A 50 male patient is brought to your emergency department by ambulance post cardiac arrest. He has an adrenaline infusion running at 100mcg/min, has been intubated in the field by paramedics and has had a protracted resuscitation period with 10mg of adrenaline given in the field, for repetitive loss of ROSC. The patient is very…

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You’ve had a horrible, horrible shift. The resus went wrong, you couldn’t intubate, the ortho reg was a schmuck. You were glad to finish your shift. You head for the carpark and you can’t wait to get home… You get to your car and you’ve got a flat. You fu%7*g piece of s!$t. You get everything out of…

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You’ve had a horrible, horrible shift. The resus went wrong, you couldn’t intubate, the ortho reg was a schmuck. You were glad to finish your shift. You head for the carpark and you can’t wait to get home…you’ve got to study for this exam. You get to your car and you’ve got a flat. You fu%7*g piece of…

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We often see patients presenting with SVT. They often have ST changes, so we have to ask; Is SVT an ischaemic arrhythmia? The answer is no, but beware as it can trigger ischaemia. Let’s look at some cases. ST segment depression occurs during supraventricular tachycardias but is transient and usually resolves following conversion to sinus…

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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 lower leg the day before, in a game of football. He continued to play at…

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‘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. It’s been going on for some time. However recently, there has been a startling growth…

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This is a great case that highlights how important it is, to know how to check if your ECG lead placement is correct. It also includes a rare case of dextrocardia. CASE A 39 yo male presented to the Emergency Department with crushing chest pain, that was associated with diaphoresis and shortness of breath. There…

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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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