Opioids are obviously our bread and butter in emergency medicine, what more is there to know? This post is designed to give you a few extra tips and some idiosyncrasies with some of the other opiates to assist you in your clinical management.
Gamma-Hydroxybutyrate - GHB has many names including: Cherry meth, liquid Fanta, Easy Lay, Fantasy, Georgia Homeboy, Liquid Ecstasy, Liquid G and most annoyingly...water. GHB is the opposite of Amphetamine, instead of making you angry and hypervigilant it depresses your CNS. It is a precursor and metabolite of gamma-aminobutyric acid (GABA - the inhibitory neurotransmitter).
Cocaine is a classic sympathomimetic, used by the Incas as an appetite suppressant and noted for its analgesic properties we now use it medically as a local anaesthetic (Sodium channel blockade of the nerves).
Marijuana is the most widely used illicit drug in Australia, most people have a pleasant experience with the psychoactive drug. Cannabinoids can have adverse effects particularly in children if high doses are consumed which result in CNS depression and a coma lasting up to 36 hours.
An uncommon presentation but you need to know that barbiturates can cause a profound coma mimicking brain death. Without good supportive care this overdose or mis-adventure can be lethal.
Amphetamine toxicity and how to manage the severe complications in the emergency department.
A 24 year old man is brought into the ED with an injury suffered playing touch rugby. He tried to stop and turn suddenly just as another player collided with him. Describe his X-ray
Briefly discuss the information (including clinical features / investigations) that may help determine the prognosis of patients following cardiac arrest.
Well that's it, just like that the conference has come to end. The last few days have been a wild ride through the essentials of emergency medicine. Mel Herbert and his team have put on one hell of a show, and San Francisco played host superbly
A 67-year old male is brought to hospital by ambulance with severe chest pain, sweating, vomiting and syncope. LMCA Occlusion
The Ten Commandments of Clinical Research according to Stoller and Mireles-Cabodevila.
Could UCEM have found the panacea for some of the greatest challenges facing Waiting Room Medicine? You be the judge...