This week’s ECG Exigency serves up 5 different risky rhythm strips. Each tells a story. Can you work out what is happening before its too late? What would you do to save the day?
Another Poke in the Eye
September 6, 2010 By View Comments
A 57 year-old man presents to the emergency department after being accidentally poked in his left eye by his grandson. He complains of sharp pain on the surface of his eye and photophobia. He refuses to open his eyelids until you instill a few drops of topical anesthesia. Can you help him?
Pain free and in VT?
September 1, 2010 By View Comments
“Can you take a look at the patient in bed 2? I think he’s having runs of VT!” You are called to the monitored area in ED to see a 62-year man who is awaiting a bed under the medics for investigation of an episode of chest pain earlier in the day. He is currently pain free, sat up in bed looking undistressed with a blood pressure of 150/90. The monitor shows intermittent runs of a broad complex rhythm. Can you interpret his ECG?
Blunt Trauma to the Eye
August 31, 2010 By View Comments
Your Emergency Department Director decided that a team-building exercise at the local boxing gym would be a good idea. You are left to hold the fort at work. An hour later the Director is en route to the ED – it seems that someone has given him a good whack in the eye… Hopefully you know your stuff when it comes to blunt trauma to the eye.
Crime Scene Echocardiography
August 30, 2010 By View Comments
In this special episode of ‘Crime Scene Echocardiography: Vienna’, the 123sonography team show how echocardiography can be used for good as they put their skills to the test and try to solve a mysterious case of dyspnea in a 39 year-old man.
Half an 8 ball
August 30, 2010 By View Comments
A 26 year-old man sustained an injury of uncertain mechanism to his left eye while at the bottom of a ruck during a game of rugby. Fortunately, his team went on to win the game of rugby 24-16. However he still has a problem. Can you sort it out for him?
Bump and blur
August 29, 2010 By View Comments
A 71 year-old man tripped at home and bumped his forehead on the wall as he went to ground. He did not lose consciousness and apart from a minor bruise on his forehead and a major bruise on his ego, his only complaint is markedly blurred vision in his right eye. He has had previous cataract surgery on both eyes. How are you going to manage this case in the emergency department?
Out of Sight
August 28, 2010 By View Comments
We’re coming to the end of an absolutely eyeful Ophthalmology August here at LitFL. Over the month we’ve considered many different causes of loss of vision. Today’s Q&A’s will bring together all the different ways the ‘lights can go out’. Are you ready for the ‘loss of vision challenge’?
A Woman of Singular Vision
August 27, 2010 By View Comments
A 56 year-old female presents with sudden onset loss of vision in her right eye. She has a past medical history of hypertension, hyperlipidema and medication-controlled diabetes mellitus type 2. Her medications include aspirin, ramipril, atorvastation and metformin. On examination she has 6/60 vision in her right eye. Can you make the diagnosis and help to preserve her eyesight?
A Man of Singular Vision
August 26, 2010 By View Comments
A 52 year-old man presents with sudden onset loss of vision in his right eye. He has no other symptoms. His past medical history is notable for hypertension, hyperlipidemia and angina. His medications include aspirin, atenolol, and atorvastatin. Can you make the diagnosis and save this man’s vision?
More Befuddling Pupillary Asymmetry
August 25, 2010 By View Comments
A man presents with a persistent cough… but you notice something wrong with his eyes. What is the ocular finding and what is your approach to determining the cause?
An Electrocardiographic Exigency
August 25, 2010 By View Comments
A 23 year-old man is brought in by paramedics after an episode of syncope at home. On arrival he is in severe respiratory distress, extremely pale and dripping with sweat. BP is 125/70, HR is 80bpm, RR 40, SaO2 95% on 15L O2 via NRB. Portable CXR in resus is normal.
Can you interpret his ECG?
He who is not forgotten will not die
August 24, 2010 By View Comments
When times get tough and external stressors tip the scales of emotional imbalance towards the darkness of unchartered thought…I seek solace in the sagacious mantra and steadfast oration of eloquent preceptors. One such inspirational raconteur, inspiring optimism in the face of adversity was Dr Randy Pausch.
I can see clearly now
August 24, 2010 By View Comments
The Goggle-eyed Fisherman
August 23, 2010 By View Comments
A fisherman presents with headache, fevers, left eye pain and swelling and visual disturbance. What is your diagnosis and how will you manage the case?
You’re blind and your hair is a mess
August 22, 2010 By View Comments
A 65 year-old man presents with sudden onset painless loss of vision affecting the lower half his right eye’s visual field. He says he skipped breakfast because it hurt to chew, and his hair is mess because it was too painful to comb. Can you diagnose and manage this condition in the emergency department?
Stressed and branching out
August 21, 2010 By View Comments
A 24 year-old medical student presents to the emergency department with 2 days of superficial left eye pain, mild redness, tearing and mild photophobia. She has a history of cold sores and has been stressed out by exams recently. The slit lamp reveals a distinctive corneal lesion…
Instructional Ultrasound
August 20, 2010 By View Comments
Today I stumbled across what looks to be the first in a series of instructional videos on Ultrasound in the emergency department from a group of ED physicians in Nambour on the Sunshine Coast in Queensland. This video is a great example of an elegant teaching style, recorded and video and shared with the world – great work guys, will be following closely to see what you are up to next.
A gritty sticky red eye
August 20, 2010 By View Comments
A patient presents with sticky, gritty, red eyes. A common and easy emergency department problem, right? Can you diagnose and treat all the different types of this condition?
ED Thoracotomy: Is it Just the First Part of the Autopsy?
August 19, 2010 By View Comments
Thoracic trauma is one of the leading causes of death in all age groups and accounts for 25-50% of all traumatic injuries. The majority of thoracic trauma patients require conservative management only, however a subset of these patient will deteriorate in the pre-hospital environment or in the emergency department requiring an emergency thoracotomy to allow the heart to keep contracting and perfusing vital organs.
