Oxy morons. Avoid prescribing oxycodone

It has been interesting moon-lighting at another hospital to see how much oxycodone (common brands names: oxynorm and oxycontin) was being used professionally and recreationally. I was out with a friend who told me he had been given 1 1/2 oxycontin tabs by an acquaintance a while ago and had been high as a kite […]

Pull my finger

Pull my finger. Dorsal dislocation of PIP

A young adult male sustained an open dislocation of the PIP for his middle finger while playing rugby. Hopefully he wasn’t doing a Hopoate. The finger was neurovascularly intact.  The wound was not obviously contaminated. The finger was anaesthetised using a ring block at the level of the web space and the wound was cleaned. […]

Extradural (bilateral)

Head injury – when to CT

Various attempts have been made to create guidelines as to who should be scanned after a head injury. For someone who is not intoxicated, who has had a significant trauma and has a GCS < 13 it is usually a slam dunk: CT. For those with a GCS of 13 or 14, or they are […]

R shoulder

Old bones. Fractures can be hard to see. Get your eye in.

An 89-year-old tripped over her walker at the rest home. She had a history of a fractured R clavicle, but was not tender over her clavicle. She had pain in her R groin and R shoulder. Ctrl or Command + to enlarge, Ctrl or Command 0 (zero), to revert to normal size.  and Click to see the diagnosis Undisplaced fractures […]

inf posterior STEMI

ECG 101

An introduction to reading ECGs in ED ECG 101 from chris cresswell on Vimeo.   Ecg 101 with answers from chricres   Stamps available from: Self Inking Stamps Ltd  


Funky eyes. Alternating strabismus and impaired upwards gaze

An eye movement disorder not caused by a cranial nerve lesion This is an interesting neuro case. This is nothing you have to know for exams but it does help demonstrate some principles of eye exams, and helps us think about some important differentials such as botulism, which if we don’t think of in ED, […]

Korero Maori

How to pronounce Maori names. Ned Tapa and Chris Cresswell

Everybody appreciates it if you attempt to pronounce their name or the name of their town properly. Here Ned Tapa helps me get my tongue around some Māori names.   Letters There are only 15 letters in the Māori alphabet. 5 basic vowels and 10 consonants.   Two of the consonants are written as digraphs (two letters […]


Making use of your character strengths. Dr Johanne Egan

The theory is that by developing your strengths, rather than trying to fix your weaknesses, you get more enjoyment out of your work and will perform better. It may also help you to work well as team with others with complementary character strengths, The VIA (Virtues in Action) Institute on Character is run by Prof […]


Shoulder Dystocia. Midwife Angela Adam

Recognition and management Shoulder dystocia. Midwife Angela Adam from chris cresswell on Vimeo.   Shoulder dystocia checklist from Wanganui Hospital   Image from http://jinshin.deviantart.com/art/Shoulder-Dystocia-160523020   Music: Whai Atu by Paddy Free (featuring Richard Nunns and Waimihi Hotere)  

Three Good Things for Happiness

Positive psychology. Three good things. Dr Johanne Egan

We have evolved to watch out for bad things – dangerous things – like a lion on the veld.  If we didn’t … This “noticing badness” can, unfortunately, mean we see the worst in people and situations. We can, however, retrain us to notice the good things around us making life more pleasant, making our […]