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Paroxysmal Supraventricular Tachycardia (PSVT), is a non-ischaemic tachyarrhythmia, with which patients, not uncommonly, present to the emergency department. Methods currently available for...
The HALT-IT Trial(1) is an important trial and one we should know well. It looks at the use of Tranexamic Acid (TXA) in gastrointestinal bleeding. Prior to this trial a Cochrane systematic review...
Upper Gastrointestinal bleeding (UGIB) affects approximately 1 in 1000 of the population per year and has an overall mortality of up to 10%.
The cause of the UGIB in the patient in front of...
A 28 yo otherwise well patient has presented to the emergency department with an imminent delivery. The baby is delivered and there is some vaginal bleeding post delivery, however it doesn't...
Tonsillectomy is a common paediatric procedure. It may be a simple palatine tonsillar procedure or more complicated with adenoid removal. Unless more complex, it may be done as a day procedure and...
What are stroke mimics?
- They don't follow stroke syndromes
- The are not sudden onset
- Their severity fluctuates
- They may have other systemic signs such as:
- drowsiness
- confusion
- agitation
- fever
A 40 yo male is brought in by ambulance following a collapse His GCS at the scene was 3 Paramedics found his rhythm to be VT and he was given 11 shocks and 5mg of Adrenaline in total. He had an...
AIRWAY PEARLS
- Consider every case a difficult Intubation due to effects on anatomy and physiology
- Normal airway techniques may not be effective.
- Positioning of the patient is critical- aim for...
A 68 yo patient is brought into the ED, post cardiac arrest.
The patient collapsed whilst out. Down-time was approximately 5 minutes; bystander CPR was commenced. ROSC was present when the...
You might ask; "Why's is subclinical Atrial fibrillation important?" We know that patients in atrial fibrillation(AF) have a 5 x risk of stroke compared to those not in AF and that even short...
Does a normal ECG exclude Hyperkalaemia?
Do we treat patients with a K+ < 6.5 mmol/L?
Do ECG changes in hyperkalaemia predict a adverse outcome?
Should we treat patients with hyperkalaemia and...
Patients presenting with dizziness comprise about 4% of all emergency department presentations. Our role is to exclude central causes. To be able to do this we an approach that allows...
This is Part II in the series Dr Claire Wilkin-Marshall and Dr Adam Michael present this lecture.
An 88 yo patient is brought into the emergency department with significant bradycardia. During the evening the patient has been at home and has become incontinent, lethargic and progressively...
The patient in asystole, has a very poor prognosis. But is it really asystole?
Is there any benefit in giving one shock to that patient?
Surely we need to look at all the leads and increase the...
A 63 yo patient presents to the emergency department at 11pm at night in new atrial fibrillation with a ventricular rate of 167 bpm. There is no past medical history apart from migraine for which...
In this Papercut we review the UK-REBOA Trial.
Rapid and effective control of haemorrhage in trauma results in better outcomes. Abdominal bleeding which cannot be controlled by any other means...
Venous Excess Ultrasound is a grading system of systemic venous congestion. It is useful in the emergency department for patients whose fluid status is uncertain and can guide fluid resuscitation...
Welcome to the wonderful world of rashes. This is part one of two parts.
This EM Mastery is actually a quiz on rashes. Try it. Members login to watch the video answers.
Below you will find a series...
This is a great case that highlights how important it is, to know how to check if your ECG lead placement is correct. It also includes a rare case of dextrocardia.
CASE
A 39 yo male presented to...
Up to one third of patients with out-of-hospital cardiac arrest(OHCA) have impaired myocardial contractility and vasodilatation. The mainstay of treatment is either adrenaline or noradrenaline.
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