Winter is Coming
A case of anterior MI presenting with De Winter T waves. Learn to recognise this sign of critical LAD stenosis on the ECG...
Is the Web killing the Impact Factor?
A recent paper has shown that the rise of the web correlates with decreasing importance of the journal impact factor.
Choose Emergency Medicine
One of my favourite tweets from #smaccGOLD was the re-invigoration of the Emergency Medicine mission statement and recruitment flyer
ECG Case 079
57 year old female presents following a collapse at work. Describe and interpret this ECG. LITFL Top 100 ECG
Potassium toxicity
Potassium clearly has its potential for risks including life-threatening hyperkalaemia and cardiac arrest. It is very concerning that the slow-release preparation is available in bottles of 100 without prescription. Aggressive decontamination and haemodialysis are indicated in large overdoses.
Thyroxine toxicity
Thyroxine overdose rarely causes hyperthyroidism, if it does, symptoms are usually mild and can be managed as an outpatient.
Mercury toxicity
Fortunately mercury poisoning is very rare. The risk of toxicity depends on the type of mercury you have been exposed to. Elemental mercury is found in thermometers, barometers, paints, and pigments, these are benign presentations unless aerosolised
Theophylline toxicity
Theophylline has a narrow therapeutic index, both acute and chronic overdose is potentially life-threatening requiring aggressive supportive care and dialysis to ensure a good outcome
Isoniazid toxicity
Isoniazid overdose is rare but life threatening. Isoniazid can cause refractory seizures which require the specific antidote pyridoxine. It should be thought about in cases of status epileptics where this is a relative or a potential history of TB in the family.
Baclofen toxicity
Baclofen in overdose produces a rapid onset of delirium, respiratory depression, coma and seizures. In large overdose the patient can appear brain dead and it has resulted in the pursuit of organ donation only for the patient to wake on the operating table. The mainstay of treatment is good supportive care.
ICE 007: Abdominal pain investigations
A 57 year old man presents to the ED with 18 hours of severe upper abdominal pain, fever, nausea and vomiting. He looks jaundiced, his HR is 120bpm, BP 110/60, RR 22 and his temperature is 37.8oC. He is tender and guarded in his right upper quadrant on abdominal palpation.
CICM SAQ 2011.2 Q1
List the complications and their likely underlying mechanisms specifically related to cardiopulmonary bypass that may be seen in the Intensive Care Unit following cardiac surgery.