Emergency Medicine and Education Blog
Ameritous Professor Broughton-Delirium noted with pleasure the official announcement by the WHO this week that the influenza pandemic was officially over. In a moment of psephological lucidity, he realised that this may explain the steady waning of local interest in pollyvirus infections. The supposedly great federal infection has, he insists, failed to ignite the level of concern and general panic befitting a true epidemic such as seen in Europe during the General Infection earlier this year.
A mechanically ventilated patient has high peak inspiratory pressures. You need to silence that incessant the alarm… What are you going to do?
One of the patients seriously injured in a multi-vehicle pile up is pregnant. What are the implications for radiological imaging and decision-making in trauma management?
One of the patients seriously injured in a multi-vehicle pile up is pregnant. What are the implications for trauma management?
A young man has been intubated for severe asthma. Now his blood pressure is heading for the floor. What are you going to do about it? Think you can save a life?
A patient develops hypoxia soon after intubation. Where lies the problem? Is it man or machine?
The rationale behind the ever-growing collection of Case-based Q&As on Life in the Fast Lane and what its all about.
A man is about to intubated for coma. What can be learned from a rapid neurological exam that includes assessment of eye movements? Could this be a pseudocoma?
A woman had a spinal injury from a car crash at 2 years of age; she since had spinal surgery and has a baclofen pump. Now she has a fever – what’s the cause?
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?
Half a dozen people are squeezing bags of various blood products — FFP, cryo, platelets and packed red blood cells. You try to keep your mind on the job, fighting off the dreaded realisation that you will be forced to buy your first new pair of shoes since 1998. “Damn it, these shoes are really comfortable”, you think to yourself as you squelch across the blood-soaked room. However, right now you could do without those trademark ‘ventilation ports’ that spontaneously appeared about 4 years ago…
What happens when a gang of echocardiography gurus from Vienna get together to make a website? 123sonography, that’s what. Franz Wiesbauer, Thomas Binder and colleagues have combined to produce a slick video-based teaching blog that comprehensively covers the practical art and science of echocardiography.
Ventricular fibrillation and sudden death triggered by a blunt, non penetrating, and often innocent appearing unintentional blow to the chest without damage to the ribs, sternum, or heart (and in the absence of underlying cardiovascular disease) constitute an event know as commotio cordis, which translates from the Latin as agitation of the heart.
At handover in ICU a junior resident mentions that an intubated and ventilated 68 year-old man 3 days post-cardiac surgery has developed an increasing FiO2 requirement. He says this is explained by a new left lower zone opacity on the patient’s chest radiograph. He has been placed on appropriate antibiotics to cover a hospital acquired pneumonia. You review the films… What has been missed? What cognitive bias contributed to the error?
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.
