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 things in the emergency department….why not sudden onset of headache. We know that at most,…

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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 and right eye pain. The patient has a past medical history of migraines, however these…

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Birth asphyxia is a leading cause of neonatal death. Positive pressure ventilation is the key to resuscitation. This is usually delivered by mask, although mask technique can present challenges in getting a good seal. Intubation is the procedure of choice if mask ventilation fails, however it presents difficulties within itself, with success rates being operator…

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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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Patients who present to the emergency department following a syncopal episode can be a diagnostic challenge to us. There are 5 things we should always do, to help us make the diagnosis. Before we start with the big 5, I need to make 3 general comments: Syncope is a symptom, not a condition. We need…

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Is cardioversion safe in the pregnant patient? A CASE A 24 yo female patient presents with palpitations and some dizziness. She is  G1P0 and is 28 weeks gestation. Her rhythm strip is shown below. You make the diagnosis of SVT. You try the ‘REVERT‘ approach and other vagal techniques, with no success. What medications are…

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Paediatric Resuscitation is stressful. However if we remember a few small points, it makes it so much easier. Here we specifically look at resuscitating children, not neonates. The Paediatric Resuscitation Guideline flowcharts have been purposefully made to look similar to the Adult guidelines, because the principles are the same. There are 3 main differences, discussed…

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Cardiac arrest in children is certainly less frequent than in adults. However most paediatric in-hospital cardiac arrests do not survive to discharge. Shockable rhythms are associated with a higher rate of survival. However there is some disagreement as to the first shock dose delivered and if it makes a difference: The Australian Resuscitation guidelines recommend 4…

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