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Paediatric Pearls

I’ve given a talk on Paediatric Pearls in the past. I recently revived the talk for my residents, so thought…

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resus founder: dr. peter kas

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Clinical Topics

Is it Thoracic Aortic Dissection?

The Case A 58 yo patient presents to the emergency department with central crushing chest pain that came on abruptly...

The Reverse Vagal Manoeuvre for SVT

A NEW technique for reverting SVT was published in AJEM(1) this week. The Reverse Vagal manoeuvre for SVT, is simple and safe and in a limited case series, VERY effective. SVT is not an uncommon patient presentation in the emergency...

Canadian Syncope Risk Score

Those Canadians are clever. They've given us ankle rules and knee rules and subarachnoid rules. Now a Syncope Risk Score. In 2016 the first Canadian Syncope Risk Rule was published. The aim was to predict 30 day serious outcomes. In...

A Patient with Wide Complex Tachycardia

Beware the Impersonators This week we see one of my favourite ECGs of the year. In fact I will call it that! It was sent in to me by a good friend, who goes by the alias of Dr Einthoven....

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Is it Thoracic Aortic Dissection?

The Case A 58 yo patient presents to the emergency department with central crushing chest pain that came on abruptly...

The Reverse Vagal Manoeuvre for SVT

A NEW technique for reverting SVT was published in AJEM(1) this week. The Reverse Vagal manoeuvre for SVT, is simple...

Canadian Syncope Risk Score

Those Canadians are clever. They've given us ankle rules and knee rules and subarachnoid rules. Now a Syncope Risk Score....

A Patient with Wide Complex Tachycardia

Beware the Impersonators This week we see one of my favourite ECGs of the year. In fact I will call...

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Tranexamic Acid: Did We Find Another Use?

Tranexamic Acid: Did we find another Use? So, picture a case. A 45 year old man presents to your Ed...

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...

Honey for Button Battery Ingestion?

A 25-year-old patient presents with recurrent lithium button battery ingestion. She had been admitted with the same presentation 3 week before and had undergone urgent endoscopic removal of the button battery. It was noted on the operation note, that the...

Why are we still doing log roll, FAST and rectal exams?

In the blunt trauma patient, where we are considering a pan-scan, is there a role for the log roll, the FAST scan or the rectal examination any more? Case The ambulance phone rings: “ETA 15 minutes. We have a 25 year...

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Tranexamic Acid: Did We Find Another Use?

Tranexamic Acid: Did we find another Use? So, picture a case. A 45 year old man presents to your Ed...

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...

Honey for Button Battery Ingestion?

A 25-year-old patient presents with recurrent lithium button battery ingestion. She had been admitted with the same presentation 3 week...

Why are we still doing log roll, FAST and rectal exams?

In the blunt trauma patient, where we are considering a pan-scan, is there a role for the log roll, the FAST...

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Sudden Hearing Loss

A 64 year old male is sent into the Emergency Department by an audiologist with a sudden, greater than 50dB...

Risk Stratification of Sudden Headache

This week we try something different. I interview the lead author of a recent paper on a proposed risk stratification approach to the investigation of Sudden headache. We risk stratify heart disease, we stratify pulmonary embolism and so many other...

Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on waking and improves during the day. It's worst if she coughs and bends. Today she has awoken with a headache...

Can you diagnose the cause of DIPLOPIA? Take the test.

/8
313
Created by Dr Peter Kas

Can you Diagnose the Cause of DIPLOPIA?

A 58 yo male presents to the emergency department with a complaint of "Doc I'm seeing double"
Try these 8 questions.

1 / 8

If you think that the patient has MONOCULAR DIPLOPIA

2 / 8

In terms of BINOCULAR DIPLOPIA, which of the following is correct?

3 / 8

Which cranial nerve is affected here?

Source: October 2011Case Reports in Neurology 3(3):248-51

4 / 8

Which cranial nerve is affected here?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

5 / 8

Look at the following image. Which Cranial Nerve is involved?

Source: Oman J Ophthalmol. 2014 May-Aug; 7(2): 103–104

6 / 8

In the following image, when would you expect diplopia to occur?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

7 / 8

Multiple cranial nerve abnormalities and any headache require an urgent CT brain looking for:( 2 correct answers)

8 / 8

Cranial Nerve III paralysis can be complete or incomplete.
In terms of clinical findings in CN III paralysis, which of the following is true?(3 correct answers)

Your score is

The average score is 50%

0%

Read the Blog on Diplopia.

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Sudden Hearing Loss

A 64 year old male is sent into the Emergency Department by an audiologist with a sudden, greater than 50dB...

Risk Stratification of Sudden Headache

This week we try something different. I interview the lead author of a recent paper on a proposed risk stratification...

Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on...

Can you diagnose the cause of DIPLOPIA? Take the test.

/8
313
Created by Dr Peter Kas

Can you Diagnose the Cause of DIPLOPIA?

A 58 yo male presents to the emergency department with a complaint of "Doc I'm seeing double"
Try these 8 questions.

1 / 8

If you think that the patient has MONOCULAR DIPLOPIA

2 / 8

In terms of BINOCULAR DIPLOPIA, which of the following is correct?

3 / 8

Which cranial nerve is affected here?

Source: October 2011Case Reports in Neurology 3(3):248-51

4 / 8

Which cranial nerve is affected here?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

5 / 8

Look at the following image. Which Cranial Nerve is involved?

Source: Oman J Ophthalmol. 2014 May-Aug; 7(2): 103–104

6 / 8

In the following image, when would you expect diplopia to occur?

Source: September 2006Comprehensive ophthalmology update 7(5):215-21; discussion 223-4

7 / 8

Multiple cranial nerve abnormalities and any headache require an urgent CT brain looking for:( 2 correct answers)

8 / 8

Cranial Nerve III paralysis can be complete or incomplete.
In terms of clinical findings in CN III paralysis, which of the following is true?(3 correct answers)

Your score is

The average score is 50%

0%

Read the Blog on Diplopia.

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  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Risk Stratification of Sudden Headache

This week we try something different. I interview the lead author of a recent paper on a proposed risk stratification...

A new DAWN for stroke treatment

Last week we looked at a case study involving a patient who awoke with stroke symptoms. In these cases there has been little to offer patients. Thrombolysis has no application here, given its 3-4 hour window. Endovascular mechanical thrombectomy has...

BP Control in Intracerebral Bleeds

A/Prof Peter Kas looks at the topic, of how tightly we must control the blood pressure intracranial bleeds.

Not SAH: Are We Done?

A/Prof Peter Kas looks at the patient who has presented with sudden onset of headache and you have ruled out subarachnoid haemorrhage. He asks the question “Are We Done?” The answer is no. Watch to see the other diagnosis, that...

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Risk Stratification of Sudden Headache

This week we try something different. I interview the lead author of a recent paper on a proposed risk stratification...

A new DAWN for stroke treatment

Last week we looked at a case study involving a patient who awoke with stroke symptoms. In these cases there...

BP Control in Intracerebral Bleeds

A/Prof Peter Kas looks at the topic, of how tightly we must control the blood pressure intracranial bleeds.

Not SAH: Are We Done?

A/Prof Peter Kas looks at the patient who has presented with sudden onset of headache and you have ruled out...

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Guidelines for the Diagnosis and Management of DVT and PE

This is a review of the updated guidelines on Diagnosis and Management of DVT and PE, which were released in...

Let’s MacGyver some equipment for COVID-19

We all remember MacGyver. He'd had a toothpick and a piece of thread and voila, he's create a rocket launcher out of it. Far-fetched and fun. Well there are a lot of very clever and inventive Critical Care docs out...

How to Read the CTPA

CTPA's are sometimes quite confusing to read. A simple approach, based on differentiating the anatomy is the approach to take. Below Dr Kas takes us through the reading of the CTPA. https://vimeo.com/313498557

5 Things to Think About in a Wheezy Child

Minimal Handling Stop touching the patient.  Often enough in paediatrics, more is not better. This is of key importance in the younger age group. The more lights/monitors and hands on assessment – the more distressing to the child. The more...

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  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Guidelines for the Diagnosis and Management of DVT and PE

This is a review of the updated guidelines on Diagnosis and Management of DVT and PE, which were released in...

Let’s MacGyver some equipment for COVID-19

We all remember MacGyver. He'd had a toothpick and a piece of thread and voila, he's create a rocket launcher...

How to Read the CTPA

CTPA's are sometimes quite confusing to read. A simple approach, based on differentiating the anatomy is the approach to take....

5 Things to Think About in a Wheezy Child

Minimal Handling Stop touching the patient.  Often enough in paediatrics, more is not better. This is of key importance in...

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Get notified on all upcoming Conferences PLUS our Webcasts, Education Newsletters, and more!

  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Thyrotoxicosis Quiz

A 50 year old female presented to the emergency department with anxiety, palpitations and feeling generally unwell.  She had no...

Thyrotoxicosis

A 50 year old female presented to the emergency department with anxiety, palpitations and feeling generally unwell.  She had no past medical history and was on no medications.  She had, however, seen her GP the week before complaining of 2...

A 29 yo male with sudden onset of flaccid paralysis

The Case A Previously well 29 year old male awoke at 0630hrs unable to move his torso or limbs. His initial complete paralysis had lessened somewhat after 2 hrs and he had managed to reach the phone and call for...

Hyponatremia

Hyponatremia is a common electrolyte abnormality. It can be acute or chronic. It can occur in isolation or as part of other disease processes.  Diagnosing its cause can be challenging in the Emergency Department and there may be some confusion...

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Thyrotoxicosis Quiz

A 50 year old female presented to the emergency department with anxiety, palpitations and feeling generally unwell.  She had no...

Thyrotoxicosis

A 50 year old female presented to the emergency department with anxiety, palpitations and feeling generally unwell.  She had no...

A 29 yo male with sudden onset of flaccid paralysis

The Case A Previously well 29 year old male awoke at 0630hrs unable to move his torso or limbs. His...

Hyponatremia

Hyponatremia is a common electrolyte abnormality. It can be acute or chronic. It can occur in isolation or as part...

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Cannabis Hyperemesis

We've all seen Cannabis hyperemesis and it's not pretty. The patient showers and feels much better..... and keeps wanting to shower...

I’ve Got this ‘Nanging’ feeling: Nitrous Oxide Abuse

'Nanging' is the recreational use of nitrous oxide. That cylinder you have in your emergency department and use for some uncomfortable procedures, especially on children.....that nitrous is now being abused on the street, with some disastrous consequences. It's nothing new....

Cyanosis or Something Else?

A 75 year old gentleman presented with acute on chronic abdominal pain. His triage noted that he was “centrally cyanosed, but comfortable” and that his daughter had reassured the concerned triage nurse that his skin was usually that colour and...

Massive Propranolol Overdose

Massive propranolol overdose is perhaps one of the most challenging overdoses to manage. In 2009 we posted a case we had. We have progressed in our management since then. CASE A 26 yo woman is brought to the ED by...

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Cannabis Hyperemesis

We've all seen Cannabis hyperemesis and it's not pretty. The patient showers and feels much better..... and keeps wanting to shower...

I’ve Got this ‘Nanging’ feeling: Nitrous Oxide Abuse

'Nanging' is the recreational use of nitrous oxide. That cylinder you have in your emergency department and use for some...

Cyanosis or Something Else?

A 75 year old gentleman presented with acute on chronic abdominal pain. His triage noted that he was “centrally cyanosed,...

Massive Propranolol Overdose

Massive propranolol overdose is perhaps one of the most challenging overdoses to manage. In 2009 we posted a case we...

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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...

Snake Bite

This year at EMCORE 30-31st May, we are proud to have Dr Ken Winkel, Toxicologist and Director of the Australian Venom Research Unit at the University of Melbourne,  talking about cold blooded bites. Here is a recent article by Dr Winkel...

Box Jellyfish stings: To vinegar or not?

The call came: a case of Box Jellyfish(Chironex fleckeri) envenomation in a young girl and her father. The father was stable and pain was under control, however the daughter had such significant pain that, anti-venom had to be used. The wound had...

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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...

Snake Bite

This year at EMCORE 30-31st May, we are proud to have Dr Ken Winkel, Toxicologist and Director of the Australian...

Box Jellyfish stings: To vinegar or not?

The call came: a case of Box Jellyfish(Chironex fleckeri) envenomation in a young girl and her father. The father was stable and...

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Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on...

The man with the croaky voice

A 42 year old male presents following having been punched to the throat. He is sitting comfortably in a chair, writing in a journal. No-one is really concerned. I’m asked to see him because he has a croaky voice? Hmmmm...I’m...

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Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on...

The man with the croaky voice

A 42 year old male presents following having been punched to the throat. He is sitting comfortably in a chair,...

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  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on...

The man with the croaky voice

A 42 year old male presents following having been punched to the throat. He is sitting comfortably in a chair, writing in a journal. No-one is really concerned. I’m asked to see him because he has a croaky voice? Hmmmm...I’m...

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  • We respect your privacy
  • This field is for validation purposes and should be left unchanged.

Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on...

The man with the croaky voice

A 42 year old male presents following having been punched to the throat. He is sitting comfortably in a chair,...

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  • We respect your privacy
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Retinal Detachment

An elderly patient presents with worsening vision in one eye over the last 2 days. There is no pain and...

Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on waking and improves during the day. It's worst if she coughs and bends. Today she has awoken with a headache...

Lateral Canthotomy

When and How to Perform a Lateral Canthotomy A 35 yo woman presents to your rural emergency department. She has recently had eye surgery at a large tertiary centre and has been allowed home. Her presentation to the emergency department is:...

Aschner Phenomenon in Traumatic Enucleation of the Eye

Introduction Aschner phenomenon or oculocardiac reflex is characterised by an episode of dramatic bradycardia following manipulation of extra-ocular muscles or dramatically raised intraocular pressure. The phenomenon was first described by Aschner and independently by Dagnini in 1908 (1,2). The phenomenon...

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Retinal Detachment

An elderly patient presents with worsening vision in one eye over the last 2 days. There is no pain and...

Idiopathic Intracranial Hypertension

A 28 year old woman presents to the emergency department with one week of headaches. The headache is worst on...

Lateral Canthotomy

When and How to Perform a Lateral Canthotomy A 35 yo woman presents to your rural emergency department. She has recently...

Aschner Phenomenon in Traumatic Enucleation of the Eye

Introduction Aschner phenomenon or oculocardiac reflex is characterised by an episode of dramatic bradycardia following manipulation of extra-ocular muscles or...

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Don’t Miss the Occult Fracture

A normal X-ray does not necessarily exclude a fracture. It is simply a test used, with our pre-test probability to...

Pronator Quadratus Sign

The pronator Quadratus sign is a sign seen on the lateral X-ray of the wrist/forearm and can assist in diagnosing an occult radial fracture. The line represents a fat pad that lies parallel to the distal radius, over the fascial...

Compartment Syndrome

Compartment Syndrome, is usually straightforward to pick up. How do we measure Compartment pressures? Below is a MacGyver setup. CASE A 21 yo male presents to the emergency department with a very painful leg. He was tackled to the right...

Gilula’s Carpal Arcs

Gilula's carpal arcs are used to determine carpal alignment. They can assist in identifying ligamentous injury, dislocations and fractures of the carpus on X-ray. They are of used in the sometimes difficult to interpret x-rays of the carpal bones. As...

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  • We respect your privacy
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Don’t Miss the Occult Fracture

A normal X-ray does not necessarily exclude a fracture. It is simply a test used, with our pre-test probability to...

Pronator Quadratus Sign

The pronator Quadratus sign is a sign seen on the lateral X-ray of the wrist/forearm and can assist in diagnosing...

Compartment Syndrome

Compartment Syndrome, is usually straightforward to pick up. How do we measure Compartment pressures? Below is a MacGyver setup. CASE...

Gilula’s Carpal Arcs

Gilula's carpal arcs are used to determine carpal alignment. They can assist in identifying ligamentous injury, dislocations and fractures of...

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  • We respect your privacy
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Paediatric Pearls

I've given a talk on Paediatric Pearls in the past. I recently revived the talk for my residents, so thought...

Phenytoin and Levetiracetam: EcLIPSE and ConSEPT trials

There has been a longstanding discussion over which is the best second-line agent to use in paediatric seizures and more specifically in convulsive status epilepticus. We now have two trials that have tried to answer this question by comparing Phenytoin...

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...

Paediatric Heart Conditions You MUST KNOW

Congenital heart conditions present at birth, but can also present within the first month of life. We look at a simplified approach to the assessment and management of patients presenting with symptoms of congenital heart disease. In this video Dr...

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Paediatric Pearls

I've given a talk on Paediatric Pearls in the past. I recently revived the talk for my residents, so thought...

Phenytoin and Levetiracetam: EcLIPSE and ConSEPT trials

There has been a longstanding discussion over which is the best second-line agent to use in paediatric seizures and more...

Syncope in Children

Syncope is not uncommon, occurring in up to 25% of children. Most causes are benign, however we need to be...

Paediatric Heart Conditions You MUST KNOW

Congenital heart conditions present at birth, but can also present within the first month of life. We look at a...

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Exam Resources

FELLOWSHIP EXAM

The Written Fellowship Course is the definitive course to help you prepare for your fellowship examination. If you want structure and a trusted way to pass the examination, then look at the course.

Learn More

OSCE EXAM

This is the 2 days OSCE Course for the Emergency Medicine Fellowship. PASS THE OSCE, with total preparation. Seats are capped in number to allow better teaching.

Learn More

PRIMARY EXAM

What if you could learn the most important parts of the Primary Exam? What if you had over 3000 MCQs to practice with? You do. The Primary Exam Course is here.

Learn More

ECG Topics

Is it Thoracic Aortic Dissection?

The Case A 58 yo patient presents to the emergency department with central crushing chest pain that came on abruptly and moved through to his back. The pain was rated as being 8/10. There was no shortness of breath, no...

A Patient with Wide Complex Tachycardia

Beware the Impersonators This week we see one of my favourite ECGs of the year. In fact I will call...

5 Things you Must do when Patients Present with Syncope

Patients who present to the emergency department following a syncopal episode can be a diagnostic challenge to us. There are...

Is SVT an ischaemic arrhythmia?

We often see patients presenting with SVT. They often have ST changes, so we have to ask; Is SVT an...

ECG Topics

Airway Topics

Should we intubate in the ramped position?

I’ve spoken on awake intubationat the EMCORE Conferences, especially at the last Masterclass. I also spoke about the potential benefits of...

5 Things To Help You Get The Airway

1. Know When To Intubate The Advanced Airway is not just about doing, but also about thinking. It may sound...

Difficult Airway Cases: What would you do?

Airway management is frightening, especially if you don't do it often. Having a plan when we approach an airway is important. My plan involves: Maximising oxygenation with apnoea oxygenation Using...

Should we intubate in the ramped position?

I’ve spoken on awake intubationat the EMCORE Conferences, especially at the last Masterclass. I also spoke about the potential benefits of intubating patients in the ramped positionie., head of the bed up at...

5 Things To Help You Get The Airway

1. Know When To Intubate The Advanced Airway is not just about doing, but also about thinking. It may sound strange, but we should have an approach that allows us...

My Rules for Getting the Airway

There are all these fancy terms out there in respect to airway. There's apnoeic oxygenation, delayed sequence intubation, the vortex...

3 Essential things to do to get the Airway

Well, I'm now writting the lectures for the EMCORE Conferences for Hong Kong,  Melbourne and Fiji and I was quite excited about this content and wanted...

An Unusual Foreign Body in the Airway

During a recent stint at a regional base hospital in NSW I was faced with an interesting clinical challenge that, at the time, I thought was most unusual. It appears...

My Rules for Getting the Airway

There are all these fancy terms out there in respect to airway. There's apnoeic oxygenation, delayed sequence intubation, the vortex etc..... Let me tell you something, you already know. This...

3 Essential things to do to get the Airway

Well, I'm now writting the lectures for the EMCORE Conferences for Hong Kong,  Melbourne and Fiji and I was quite excited about this content and wanted to share some of it with you. Today I wanted...

Airway in COVID-19

I have a lot of questions. Here are some answers and a few resources for you. This is all uncharted territory....

VAPOX and Ventilation During the Apnoeic Period

In Rapid Sequence Intubation(RSI), there is that period of apnoea that occurs following delivery of paralytics and prior to attempting...

Effectiveness of Apnoeic Oxygenation Questioned

Everyone knows I'm a huge fan of apnoeic oxygenation. I use it for sedation, for intubation, heck I sprinkle some on my cereal in the morning. But here is a...

Airway in COVID-19

I have a lot of questions. Here are some answers and a few resources for you. This is all uncharted territory. We have some evidence from SARS and  other instances that...