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Posts by Dr Peter Kas

Thyrotoxicosis SAQ

Test your knowledge by answering this question in 12 minutes 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 weeks of palpitations, anxiety and…

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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 with spontaneous tongue, lip and face swelling. His only medical history is hypertension, for which he takes perindopril…. I could give you a lot more diagnostic information – vital signs, symptoms etc to facilitate you…

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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 weeks of palpitations, anxiety and weight loss.  Her GP had checked her thyroid function tests…

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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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Resuscitation Literature Review October 2019

This week, I wanted to quickly review some of the latest resuscitation literature. Let’s look at 3 studies. STUDY 1 Yamamoto M et al. Diagnostic value of lead aVR in electrocardiography for identifying acute coronary lesions in patients with out of hospital cardiac arrest. Resuscitation 2019 142:97-103 Background Emergency coronary angiography is currently recommended in…

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