Lucky to be here

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“Which snakes possess the deadliest venoms?” is a question sandnsurf has answered previously here at Life In The Fast Lane. He quite rightly noted that having the deadliest venom isn’t the same as being the deadliest snake. In fact, human factors are extremely important when it comes to getting bitten by a snake, and in [...]

Is this a RedBack I see before me?

Redback Spider

Toxicology conundrum about the redback spider… in Japan!

Code Black

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“Code Black” in Cubicle 23. The doctor stood impassively before the wildly agitated “speeding” patient. She was ranting and gesticulating aggressively, with eyes wide and teeth flashing. Unsurprisingly, words alone did nothing to calm her down. The doctor, in a matter-of-fact tone, told her that if she didn’t cooperate she would be sedated against her [...]

Smith, Bell, and the Art of Observation

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Sir Sydney Smith relates the ultimate lesson in the art of observation by Joseph Bell, the inspiration for Sherlock Holmes and forensic science

PFO and the consequences

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“PFO”…”Not another TLA”, I hear you groan… PFO is a three letter acronym that stands for “pissed, fell over“… A disturbingly frequent presenting complaint to emergency departments around the world. Here’s a bar chart showing the pattern of injuries that result from PFOs, according to blood alcohol concentration: The bottom line according to @precordialthump: At [...]

Bitten by a Redback Spider

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A 27 year-old woman felt a sting on the back of the right leg while pulling on her tracksuit pants. She investigated further and discovered a small black spider, with a red-stripe on its back, crawling around in her tracksuit pants.

Unusual Urine 004

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A 72 year old female is admitted following an emergency abdominal aortic aneurysm repair. The day after her surgery, the following biochemistry results are obtained:

Suffering together

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I was having a busy week at work. At 2:30 am one night I finally got to see an 89 year-old man quietly waiting in a corner cubicle. Some hours earlier he was brought to the ED by an ambulance after the onset of progressively worsening abdominal pain. He’d been given analgesia on arrival and [...]

Poisoning by a mercury thermometer

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Your next patient is an 80 year old man suffering from Alzheimer’s dementia. He was brought into the ED by his wife and daughter who are his care-givers.

Paracetamol… Too much, too often?

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You are called by a doctor in a remote hospital asking for advice. The doctor is concerned about the risk of hepatotoxicity from repeated supratherapeutic ingestion (RSI) of paracetamol in the following patient:

A 46 year old male (75 kg) with 2 days of low back pain. He has self-medicated with a total of 10g of paracetamol over the past 48 hours: