Emergency Medicine and Education Blog
A 32 year-old woman is referred to the ICU post caesarean section. She had an uneventful elective caesarian section 10 hours previously. She has been referred because in the last 2 hours she has developed vaginal bleeding and oozing from her epidural site. Her vital signs are unremarkable except for a small oxygen requirement. The following coagulation results are obtained:
In response to concern (baseless) that the recent uncovering of the Society for the Prevention of Surgery was in some way meant to discredit the invaluable work of our Anaesthetic colleagues, Professor Staghorn and the Board of UCEM have undertaken and exhaustive search of the literature and have found a recent clinical trial that may alleviate the inadvertent emotion pain we have caused.
An elderly man with a nasty looking chest x-ray is treated with penicillin. Should the antibiotic be changed in light of his sputum MCS?
All Whites: undefeated in the World Cup since 1982.
A 26 year old male presents with nausea, vomiting and confusion. The following blood gas is obtained on admission
A 19 year old male is admitted after a severe traumatic brain injury. Due to refractory intracranial hypertension he is intubated and receiving 20mg an hour of morphine, 20mg an hour of midazolam and 200mg an hour of propofol. He is paralysed for intracranial pressure control. You are called to the bedside because he has desaturated to the mid 80s on 100% oxygen. A chest X-ray is obtained.
A previously well 50 year old presents with sharp severe chest pain after a long haul flight from North America. A chest X-ray and ECG are performed and reveal no abnormalities. The examination is unremarkable. The patient proceeds to a CT chest.
Consider a 49 year female old smoker with two weeks of increasing shortness of breath. She is being treated for pneumonia on the ward for three days but getting worse. An ICU review is performed on the ward and the following ECG is obtained.
A 20 year old male presents with 3 days of lethargy and generalised malaise. He is confused and looks very unwell. The following blood tests are obtained:
A 45 year old woman with metastatic ovarian cancer is admitted for VATS pleurodesis and drainage of bilateral pleural effusions. Her admission chest X-ray is shown below:
You are looking after a 23 year old male who has a subarachnoid haemorrhage and the nurse calls because the patient has started to pass unusual urine:
A 3o year old male presents with a 3 day history of fevers and increasing breathlessness. On presentation he is noted to be severely hypoxic with sats of 80% on room air. The following chest X-ray is obtained:
An 87 year old female presented with a subarachnoid haemorrhage. GCS 8/15. A nasogastric tube was unable to be placed due to patient agitation. As a consequence, the patient was fasted for five days due to concern about swallowing. Subsequently, an arterial blood gas was obtained:
A 38 year old male with a background history of type 2 diabetes presents with fevers, rigors and pain on swallowing. There is no sign of impending airway compromise; however, marked trismus is noted. The following plain X-ray is obtained:
A 67 year old gentleman with a BMI of 45 was waiting for his respiratory outpatient clinic appointment. While waiting, he fell asleep. A medical emergency was called because he could not be woken up. On arrival of the MET team the patient is found to have a blood pressure of 140/70, a heart rate of 100bpm and oxygen sats of 68% on room air. He is breathing spontaneously but requires airway support. His GCS is 3/15. Supplemental oxygen is applied and the following arterial blood gas is obtained.
Consider a 65-year-old male presenting with flank pain radiating to the groin. The following CT scan was taken to confirm a presumed diagnosis of renal colic
A 17 year old female with a background history of HIV presents with a 3 day history of fevers, chills and rigors. Her admission chest X-rays are shown below:
Consider a 16 year old who presents with a 3 week history of severe hip pain followed by increasing breathlessness and left sided chest pain. His admission chest X-ray is shown below:
A 50 year old Chinese female presents with severe weakness. She has a history of previous similar episodes that self-resolved.
A 21 year old female presents with acute onset of unrelenting abdominal pain and vomiting four years after a major motor vehicle accident. A chest X-ray is performed:
