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Archive for April 2019

Capnography

Understanding capnography and being able to decipher the waveforms, can give us critical information on a patient’s condition, early. Below are 3 cases, where we look at some of the potential waveforms we might encounter in the intubated patient in the emergency department. What does it tells us? Capnography gives information on: Metabolism: Responsible for the…

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Is there anything New in Cardiac Failure?

In this video, A/Prof Kas looks at the new guidelines on heart failure and really shows that not much is new. The approach should still be: A decrease in preload /afterload- GTN A recruitment of alveoli by CPAP or BiPAP Frusemide but only recognised as a delayed working agent.

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The 6 Human Needs

As part of a talk on ‘Dealing with Difficult People’, I gave at EMCORE Hong Kong this year, I spoke about the 6 Human Needs and how they determine behaviour. This was all in the context of dealing with difficult colleagues and the potential psychopathic behaviour we sometimes see. The key here was that, although…

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Should we bring Bretylium back in cardiac arrest?

Following a brief presentation at EMCore Hong Kong in April of this year, that challenged our thinking, I have asked our expert colleague, Dr Will Davies, to expand on an argument he put forward, (in our clinical topics series), that we should revisit the use of bretylium tosylate in cardiopulmonary resuscitation, especially in the treatment…

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Upright T wave in V1

A 65 year old woman presents with a 20 minute episode of chest pain. Her ECG is shown below. Are there any concerning features for ischaemia? Source: The west journal of EM 18(4):601-606 · June 2017(1) Significance of an upright T wave in V1 Normally the T wave is inverted or flat in lead V1.…

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Syncope in Children

Syncope is not uncommon, occurring in up to 25% of children. Most causes are benign, however we need to be aware of the of 3 major groups as these can be very serious diagnoses: Those with a cardiac cause Those with a neurological cause Very young children, as syncope shouldn’t occur in this group. Making…

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Smith’s Fracture Diagnosis and Management

A 15 yo male with a Smith’s Fracture. The patient had fallen onto his flexed left wrist during a football match. There were no other injuries, however there was a history of a right sided wrist fracture in the recent past. On examination, the wrist appeared deformed in a classic ‘garden spade shape’, however the…

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