Fever is so hot right now… ‘Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever’ — William Osler1 Fever is one of the cardinal signs of infection and — nearly 120 years after William Osler’s statement in his address to the 47th annual meeting of the American Medical Association on The Study of the … [Read more...] about Fever, Friend or Foe?
aka Metabolic Muddle 008 You are asked to review a pregnant patient (30 weeks gestation) who has been diagnosed with pneumonia. The referring doctor is concerned that she has a metabolic acidosis. She is currently receiving high flow oxygen with an FiO2 of 0.5. This is her arterial blood gas: Questions Q1. Describe and interpret the A-a gradient. [DDET Answer and … [Read more...] about Pregnant and Acidotic
aka Oncology Quandary 002 A 30 year-old woman presents with abdominal pain and paraesthesiae. She was diagnosed with CML 2 months previously, and was treated with chemotherapy a month prior to presentation. These are her blood test results: Describe and interpret the test results. [DDET Answer and interpretation] Description: Mild hyponatremia … [Read more...] about Troubling Lab Strife
aka Pulmonary Puzzle 015 Post coauthor: Chris Nickson A 40 year old man had been in ICU for nearly 2 weeks and was slow to wean off the ventilator due to ARDS (acute respiratory distress syndrome). A percutaneous dilational tracheostomy (PDT) was performed. Following the procedure he developed a requirement for increased respiratory support. He was sufficiently stable … [Read more...] about Puffed Post-Tracheostomy
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 Bored of UCEM have undertaken an exhaustive search of the literature and have found a recent clinical trial that may alleviate the inadvertent emotional pain we … [Read more...] about A Cure for Hurt Feelings