This is a fantastic case to learn from for a recent Circulation article(1) titled ‘An Ominous ECG Sign in Critical Care’. THE CASE A 35 year old woman, who is a known intravenous drug user, is admitted with septic shock secondary to bacterial endocarditis. She is acidotic and hypotensive. Her ECG is shown. Here are…

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We know that Double Sequential(DSED) External Defibrillation has been used primarily for the treatment of resistant ventricular arrhythmias. Here is a case study proposing its use in refractory atrial fibrillation(1) The case discussed is of a 56 year old patient with a history of paroxysmal atrial fibrillation on the background of ischaemic cardiomyopathy. The patient…

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Can Ketamine be used for the control of the agitated patient? CASE A patient is brought into the emergency department in an agitated state. There is a history of recent drug use, potentially amphetamines. The patient has been treated with Midazolam and doses of Droperidol are added. However there is a significant delay in the…

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Here are my top 8 tips for succeeding at intubation. 1. Use a Video Laryngoscope(VL), or at least have one nearby Okay, maybe a little controversial still.  But if there is some way that you can get your hands on one, have it on standby. In a  statement several years ago, Ron Walls said that VL…

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