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Archive for December 2016

Fluid Resuscitation in Pancreatitis

It is the festive season and with it, comes the patient that has more than their usual few drinks. They present to the emergency department soon after, with abdominal pain and nausea and when their lipase comes back; a diagnosis of pancreatitis. This disease carries an overall risk of mortality of 2%, but it may…

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Module 3: The QRS

The QRS When it comes to the QRS complex there are 4 questions to ask: Is it TALL or SMALL? Is it WIDE/NARROW? Does it have abnormal MORPHOLOGY i.e. DELTA wave Are the complexes CLUMPED or irregularly irregular? Are there Q waves? Password is ‘ecg’ Is it TALL/SMALL? If the complexes are TALL– think of…

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Module 1: History and Rate

1. History and Rate HISTORY The story is so important to get early. Why? Because it primes us for how to look at the ECG. Always ask, “What has the patient presented with?” If the answer is chest pain, then we can zero in on looking at ischaemic changes in the appropriate arterial territories, i.e..,…

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Module 2: The P wave and Blocks

P waves and Mobitz Blocks The P wave Look at the P waves- are they upright in II and inverted in aVR if so then normal, otherwise it’s ATRIOVENTRICULAR JUNCTIONAL OR ECTOPIC ATRIAL RHYTHM Is There a Mobitz Block? If the QRS complexes are clumped, think of a Mobitz Block. Look for the P waves.…

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Ciguatera Toxicity and Allodynia

The Case: A 60 yo male presents to the emergency department with Ciguatera Toxicity. He is frightened by the symptoms he has developed. This morning he noticed some paraesthesia around the mouth. He also noticed that when he picked up a cold bottle of water it ‘burnt’ his hand. Also when he splashed cold water…

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