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Archive for November 2019

CRASH-3 Trial

The CRASH-3 Trial has been published. CRASH-2 demonstrated that early administration of tranexamic acid(within 3 hours of injury) reduced bleeding deaths by one third(1). In CRASH-3, the investigators looked at the effects of tranexamic acid in patients with potential traumatic brain injury. The Trial International, multi-centre, randomised, placebo-controlled trial Big Trial Eligibility criteria: Within 3…

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ECG predictors of Cardiac Arrhythmias in Elderly with Syncope

CASE A 72 yo woman presents to your emergency department following an episode of syncope. There was a brief 2-3 seconds of dizziness followed by a loss of consciousness. The patient did not complain of chest pain or palpitations, nor headache, nor abdominal pain and there was no weakness, or loss of function. There was…

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Diplopia

A patient presenting to the Emergency Department with diplopia can be a diagnostic challenge. Which patients need urgent imaging and which patients can be referred to outpatients? What is the imaging of choice? A recommended approach is shown below(1): As a summary: If it’s Binocular PLUS any of the abnormalities below, perform a CT brain…

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Brachial Plexus Block and its Complications

A 40 yo patient presents with a complaint of total arm paraesthesia and global loss of power. Over 16 hours previously she had a surgical procedure on her hand. A Brachial Plexus block (axillary approach), was used to provide anaesthesia. There has not been any return of function. On examination there is a total loss…

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