Happiness in Emergency Medicine

Dr Adrian Boyle, President of the Royal College of Emergency Medicine, talks about this most important topic.

How we evaluate suspected SAH is changing

SAH has a 50% mortality and a significant morbidity in survivors. The 'warning leak' is our opportunity to make the diagnosis. In 2016 I spoke at EMCORE about the use of CT Cerebral angiography with CT and LP In 2019 ACEP recommended it, as a substitute to LP. This is the current trend. A significant increase in CTCA. Are you using it? Here are my thoughts/rambling on the topic. No edits, just talking about it for 20 minutes.

Post Tonsillectomy Bleed

Post Tonsillectomy Bleeds occur in about 5% of cases, however the chance of a second lead following a 'herald bleed' increases to 10%. Most are self limiting, however they can be major and potentially catastrophic. We discuss the approach to these patients. Listen Now

Airway Pearls for Intubating The Obese Patient

The obese patient is by definition a difficult intubation. The abnormal anatomy, decreased lung capacity,  increased metabolic activity and difficulty in ventilating, make every intubation potentially very difficult. In this podcast we share pearls that can help. Listen Now.

Resuscitative Sequence Intubation

Peri or post intubation cardiac arrest has several risk factors. We discuss hypotension, hyperaemia, metabolic acidosis and right ventricular failure and how to maximise resuscitation before intubation. Listen Now

ICU Will Not Take The Patient

An 88 yo fully independent patient is brought into ED in Cardiogenic Shock. Past history includes hypertension and hypercholesterolaemia. The pain settles and the patient  requires a small dose of noradrenaline to maintain blood pressure. ICU refuses to take the patient. We discuss mortality rates in the elderly and the sometimes frustrating access to ICU. Listen Now. 

Electrical VT Storm

A 58 yo patient has called the ambulance, as he is having palpitations and is feeling unwell. He has a past medical history of ischaemic heart disease with two coronary stents placed and a kidney transplant. He is in VT that you cannot convert to sinus rhythm. We discuss the approach to Electrical Storm. Listen Now.

Guillain Barre Syndrome

A 36 yo woman presented to the emergency department complaining of numb feet. We discuss the approach to the patient with suspected GBSand the many variants of it. Listen Now.