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Analgesia for chest drains and rib fractures
A 60-year-old construction worker fell from a roof landing on his ladder. He had multiple rib fractures, a moderate pneumothorax, small haemothorax and some pulmonary contusion. He was given morphine 10mg and ketamine 20mg in the ambulance. He was given 100µg of fentanyl on arrival in ED + 2g oral paracetamol and 800mg oral [...]
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Meditation for Patients
Meditation is a useful skill that helps many patients deal with anxiety, depression and chronic pain. It is also widely used by millions around just to improve general well-being. Professor Jon Kabat-Zinn is a professor of medicine in the United States. He has formulated many courses and written several books on meditation for patients and [...]
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When Vasodilators Are Not So Good For Heart Failure
Between a rock and a hard place. Audio: 64M with exacerbation of CCF with angina at rest. Hx 50% LAD stenosis 3 years ago -> no intervention, CCF with EF 25%, pulmonary hypertension with RV dysfunction, COPD on home O2, chronic AF on warfarin (therapeutic + d-dimer negative). He was on frusemide 40mg bd, [...]
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X Rays and CTs for New ED Doctors
This is a great little book for new doctors in ED Hopefully you will find one in your department. It is a very quick read. Read it in your first few weeks in ED – before your first night shift! Here is a good online radiology teaching resource aimed and medical students and junior doctors [...]
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Night Shifts for Junior Docs
A great introduction to night shifts for junior doctors by one of our junior doctors. Night Shift MacDonald from chris cresswell on Vimeo. Audio only: Slides only: Night shift mac donald from chricres You can down load audio here (Right click) or Night shift image from: http://www.madrasbhavan.com/2010_10_01_archive.html Music: Night Shift by The Commodores [...]
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Why Billy Mallon Doesn’t Like Digoxin
I recently presented a digoxin toxicity case. I talked about a great talk from Billy Mallon in which he described digoxin as a “Dinosaur looking for a tar pit.” I haven’t been able to track down the talk, or get Billy to re-record it, but I received this email from him: “Chris Digoxn IS [...]
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Scalp Impetigo = Head Lice Until Proved Otherwise
A 14 month old boy was referred from an accident and medical clinic with a fluctuant abscess on his occiput. He had had impetigo of his scalp and had taken a couple of courses of antibiotics with brief resolution then recurrence of the scabs. The day prior to presentation he had a 2cm lump on [...]
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Low and Slow. Calcium Channel Blocker Overdose.
60M found collapsed in park. Decreased LOC but normal obs otherwise ? OD ? faking. Hx of multiple OD. Obs normal on arrival. 5 min later HR 55, BP 70 systolic. ECG junctional bradycardia. Presumed beta blocker or calcium channel blocker. Another possibility is digoxin. d/w GP at his practice : felodipine, verapamil [...]
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Asthma. Ramamoorthy. SEMEP
Original video Audio only with an Australasian-perspective commentary from me: You can download the audio here (right-click) or Magnesium in asthma is probably ineffective in adult asthma: http://stemlynsblog.org/2013/05/jc-does-magnesium-work-in-asthma-st-emlyns/ The 3Mg Study In Australasia we are not keen on arterial blood gases on patients with asthma as they are less likely to come to hospital for [...]
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ED Orientation: Key Emergency Techniques. Part 3: More on Circulation through to Self Care and Study
Audio Download audio here or Meditation resources Sleep inducing meditation http://lifeinthefastlane.com/ http://embasic.org/ http://www.emrap.org/ http://emcrit.org/ http://ekgumem.tumblr.com/ http://emtutorials.com/
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Fish bone in throat?
An 87 year old presented with increasing throat pain 7 hours after choking on a fish bone. The X-Ray was reported as normal by the junior doctor on over-night. The patient was kept in for symptomatic relief. Next day the X-Ray was reported by the radiologist and the retropharyngeal gas was noted. No fish [...]
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Analgesia for chest drains and rib fractures
A 60-year-old construction worker fell from a roof landing on his ladder. He had multiple rib fractures, a moderate pneumothorax, small haemothorax and some pulmonary contusion. He was given morphine 10mg and ketamine 20mg in the ambulance. He was given 100µg of fentanyl on arrival in ED + 2g oral paracetamol and 800mg oral [...]
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Meditation for Patients
Meditation is a useful skill that helps many patients deal with anxiety, depression and chronic pain. It is also widely used by millions around just to improve general well-being. Professor Jon Kabat-Zinn is a professor of medicine in the United States. He has formulated many courses and written several books on meditation for patients and [...]
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Fracture management
This is a simple guide to fracture management, and other common orthopaedic presentations. It doesn’t cover spinal injuries. See X-Rays and CTs for New ED Doc for recognition and description of fractures This guide was first written by (Speedy) Dan Hartwell and myself in 2007. It has been edited by an orthopaedic consultant and continues to [...]
