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Modified Valsalva PLUS Adenosine to revert SVT Jul 23, 2024

Paroxysmal Supraventricular Tachycardia (PSVT), is a non-ischaemic tachyarrhythmia, with which patients, not uncommonly, present to the emergency department. Methods currently available for...

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The HALT-IT Trial Jul 23, 2024

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...

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Massive Upper GI Bleed Jul 23, 2024

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...

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Post-Partum Haemorrhage Jul 23, 2024

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...

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Post Tonsillectomy Haemorrhage Jul 23, 2024

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...

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Stroke Mimics Jul 23, 2024

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

...

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High Quality CPR in Cardiac Arrest Jul 23, 2024

Professor Paul Middleton looks at CPR and Cardiac Arrest. 

 

 

 

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Ketamine for Analgesia Jul 23, 2024

Dr Andrew Perry looks at using Ketamine for analgesia.

 

 

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Take the ECG Quiz Jul 23, 2024

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...

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Airway Pearls for Intubating the Obese Patient Jul 23, 2024

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...
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PEA: Do you POCUS? Jul 23, 2024

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...

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Subclinical Atrial Fibrillation: A review of 11 studies Jul 23, 2024

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...

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When to treat Hyperkalaemia Jul 23, 2024

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...

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Stroke Chameleons, The Dizzy Patient and more Jul 23, 2024

 

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...

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Having The Family in During a Cardiac Arrest Jul 03, 2024

Dr Will Davies presents.

 

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Rashes Quiz II Jul 03, 2024

This is Part II in the series Dr Claire Wilkin-Marshall and Dr Adam Michael present this lecture.

 

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BRASH Syndrome: A Case Jul 01, 2024

 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...

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EM Mastery
Shocking the patient in asystole
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Shocking the patient in asystole Jun 01, 2024

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...

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Magnesium in Atrial Fibrillation: Magic or Mush? May 30, 2024

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...

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UK-REBOA Trial May 29, 2024

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...

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Do You use VExUS? May 29, 2024

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...

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Rashes May 29, 2024

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...

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Dextrocardia: Can you pick it on ECG? May 25, 2024

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...

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Papercut: Adrenaline vs Noradrenaline in Post Arrest Hypotension May 20, 2024

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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