September 2, 2010

Pain free and in VT?

ECG

“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?

Crime Scene Echocardiography

sono2

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.

An Electrocardiographic Exigency

ECG_001

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?

Instructional Ultrasound

USS

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.

Ultrasound Village

Ret Detat

At last! Ultrasound Village, the awesome emergency medicine ultrasound educational website, is finally welcoming prospective villagers – find out all about it!

Splat! A vomiting infant

Rankin's pyloric stenosis

An infant is brought in by his concerned parents. Splat! Vomiting is the presenting complaint. Can you work out what’s going on and help this sick baby?

Lost in Translation

XRAY

Whether it is interpreting a physicians handwriting, transcribing the muffled rants of the dictating clinician or battling the auto-correct function of microsoft word…meaning can sometimes be lost in translation…

Condom Inhalation

2811556

With the Flu season upon us the Utopian College of Emergency for Medicine (UCEM) would like to remind all fondling members of their duty to take a full and appropriate past medical history. This includes a past sexual history…

Gut ache or Gordian knot?

paraduodenal hernia

A 29 year-old man has recurrent abdominal pain. Can you make the diagnosis where others have failed?

An Obstetric Bleeder

DIC

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:

Lover not a fighter

5th MC neck fracture XR

A distinctly uncommunicative man says he injured his hand in a fall. What is the diagnosis, the mechanism and how will you treat the injury?

Bone and Joint Bamboozler 004

Bennett Fracture

A 27 year-old amateur martial artist needs your help after smashing his fist through a plank of wood. Can you diagnose and manage his injury?

Bone and Joint Bamboozler 003

Volar Bartons Fracture Eponymous Fractures

A 50 year-old woman took a tumble down some steps and injured her left wrist. Can you correctly diagnose and manage her injury?

Is resistance futile?

Resistance Futile

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?

Does fat float on blood?

Lipaemia L

Your first patient of the drizzly Thursday night shift is Matthew, a man in his 30s, lying on his side on a trolley. He winces as he rolls onto his back to face you, waving aside your apology for his 3hr 47min wait; he’s in obvious discomfort and very happy to see you.

CT Safety and Radiation Risk

Is a cancer epidemic be looming over the horizon? The universality of CT as the investigation du jour, and growing concerns about the risks of radiation.

Epistaxis

Epistaxis is a frequent complaint. 60% of the population will suffer from a nose bleed during their lifetime, and 6% will require medical attention. Outline of diagnosis and management in the emergency department setting.

Pediatric Perplexity 005

RMB inhaled FB

A toddler’s respiratory distress is getting worse. He is wheezy but not responsive to bronchodilators. Could Swedish furniture be the cause?

The Future of Anticoagulation

Hirudo Medicinalis

Generally anticoagulation treatment has been focused on an initial parental anticoagulation and then extended therapy by oral anticoagulation. Drugs which block the thrombin process have been the mainstay of treatment programmes.

Nail Gun Injuries

Nail Gun

Mr Ivor Plank attended the Emergency Department on the weekend having developed a painfully strong bond with an expensive piece of skirting board…Clinical review of nail gun injuries presenting to emergency departments and the management of penetrating nail injury.