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Fluid Resuscitation in Pancreatitis

It is the festive season and with it, comes the patient that has more than their usual few drinks. They present to the emergency department soon after, with abdominal pain and nausea and when their lipase comes back; a diagnosis of pancreatitis. This disease carries an overall risk of mortality of 2%, but it may…

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A ‘Rare as Hen’s Teeth’ Diagnosis

Have you ever had one of those cases where you thought, “I am so good, picking that”, even if you didn’t say it out loud. Or have you ever had one of those diagnoses where you thought ” I am so lucky”, it didn’t go, all ordinary on me. Well here is a recent case…

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Here is a brief (13 minutes)video lecture on burns. I discuss: Initial management, including airway, fluid resuscitation, analgesia, dressing as well as the assessment of area and depth of burns. A video of this length can’t cover the absolute details but it does look at: Indicators of inhalational burns What constitutes a major burn How…

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Aortic dissection

A 70 plus year old non-English speaking gentleman presented to the emergency department with chest pain. He was a happy looking gentleman in no apparent distress, but looked very, very pale. He in fact had a ‘pre-arrest’ look about him regardless of the fact that he is smiling. He was treated with sublingual GTN for…

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Beware of making the diagnosis of renal colic!

Sometimes a little knowledge can be dangerous. Beware of just knowing the percentages, know to apply them in the clinical context.

I was recently handed over a patient who had presented with abdominal pain. The patient was reported as having some left sided abdominal pain and pain on left kidney ballottement. The diagnosis of renal colic colic had been made. The patient was being treated with oral analgesia with a view to going home when pain was under control.

The past history the patient gave was a hysterectomy a few years prior, with a complication of hernia, and a further complication of infection, post hernia repair. She had also had a secondary in the lung for which she had had a lobectomy. She did give a history of left renal colic some 19 years previously […]

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