The scope of wilderness medicine combines traditional medical specialities, particularly emergency medicine, sports medicine, military medicine and general practice, with pre-hospital care and rescue skills.
Dr Michelle Dodds BOX JELLYFISH Distribution: Tropical Australian waters, majority of stings occur from October to June. Clinical presentation: immediate severe pain that can last 8 hrs; Sting pattern – crosshatched, linear welts Systemic envenomation: sudden collapse or death within a few minutes of the sting, with cardiovascular effects including hypertension, hypotension, tachycardia, impaired cardiac […]
Safety in procedural sedation (PSA) Dr Michelle Dodds Fasting ACEM policy endorses ANZCA guidelines on sedation + analgesia 2-hours – clear liquids, 4-hours – breast milk, 6-hours – solids Consider aspiration more likely with inhalational anesthetics + manipulation of airway (less common in ED) Vomiting in PSA in ED actually rare (0.5% in QLD study […]
May Loke – Advanced Trainee Definitions : Neurocritical care guidelines 2012 5 minutes or more of clinical/EEG seizure activity OR two or more intermittent seizure activity without full recovery in between Significant increase in morbidity and mortality with seizures lasting >30minutes – Mortality rates at 1hr 30-40% for generalised status epilepticus Management points A and […]
Dr Kaushik Basu – Advanced Trainee Trauma is a important cause of morbidity and mortality in the developed countries during the first four decades of life and the burden is even higher in the developing countries. There is a need for the proper assessment of the trauma patient to have the best possible outcome. The […]
Alexander Kochi – Advanced Trainee Ultrasonography in the Trauma Room Benefits of USS: quick, accessible, portable, binary, non-invasive, repeatable, cheap used for FAST, basic echo, detection of PTx, nerve blocks, fractures, foreign bodies, placement of devices such as lines / catheters Evidence for USS: ability of USS to identify need for laparotomy in unstable patients: […]
Alistair Hamilton – Advanced Trainee Coagulopathy of Trauma Between 30-50% of multitrauma patients arrive to DEM coagulopathic This is complex, but mainly due to hyperfibronlysis / usage of factors & platelets Also contributing: hypothermia causing CF & plt dysfunction / fluid replacement (even blood) / inflammation of trauma Role of Tranexamic Acid TXA inhibits conversion […]
Dr Kaushik Basu – Emergency Medicine Advanced Trainee In our day to day practice we often come across a situation where we have to medically clear a person who is being brought to the DEM by the QPS with a medical condition and needs to be taken back to the watch-house. Patient’s medical condition can […]
Dr Peter Snelling – Paediatric Emergency Registrar Assessment of low vs high velocity injury Investigation of penetrating chest trauma The Role of the Emergency Department Thoracotomy Low Velocity Generally a sharp object causes injury along its entry track and may damage any intrathoracic organ in its path External wounds may appear deceptively innocuous (“Ice pick” […]
Dr Alistair Hamilton – Emergency Medicine Advanced Trainee Section 1 – ICC Insertions Complications of ICC’s are wide ranging, and potentially catastrophic Malposition is the most common Includes diaphragm perforation, abdominal tube, intraparenchymal tube, and tube outside the pleural space Tube migration / dislodgement Organ & neurovascular injury Pneumothorax: persistent / late / at removal Others: […]
Dr Titiosi Adegbija – Emergency Medicine Registrar Blunt Aortic Injury is the 2nd commonest cause of death in BCT patients – 80% on scene The mechanisms involved in BAI include 1) Osseous pinch 2) Water-hammer effect 3) Stretching/ shearing and 4) Torsion Management is either open surgery or endovascular repair Blunt Myocardial Injury occurs in 13% BCT […]
Lessons learned form the 100 year anniversary of ANZAC day – the entry of Australia and New Zealand into the battle of the Great War.