Hermann Boerhaave (1668 – 1738) was a Dutch physician, chemist, botanist and Christian humanist. The father of bed-side teaching. Eponymously affiliated with Boerhaave syndrome following his 1724 description of the death of Baron Jan von Wassenaer, Grand Admiral of the Dutch Fleet.
Lightning. Nature's way of showing electric current, potential, and resistance. The average cloud to ground strike is 3 miles long, and carries 30,000 amps of current. The fact that people can be struck and live is amazing.
Environmental Enigma: One of your colleagues tells you he is going to climb Mt Kilimanjaro next month. He has never been to altitude before and asks you how he can prevent altitude sickness while on his trek...
A patient has chest pain and shortness of breath. Is there a way to rule out pulmonary embolism without further investigation? Can you use the PERC rule?
An ICU patient has become increasingly 'puffed' post-tracheostomy. Can you figure out why? What are your going to do about it?
A mechanically ventilated patient has high peak inspiratory pressures. You need to silence that incessant the alarm... What are you going to do?
A young man has been intubated for severe asthma. Now his blood pressure is heading for the floor. What are you going to do about it? Think you can save a life?
A patient develops hypoxia soon after intubation. Where lies the problem? Is it man or machine?
An elderly man with a nasty looking chest x-ray is treated with penicillin. Should the antibiotic be changed in light of his sputum MCS?
aka Pulmonary Puzzler 010 A 13 year-old boy with a history of allergic rhinitis is sent in to the emergency department by his family doctor. Three days previously he was exposed to smoke from a bushfire and has been having…
A 19 year old male is admitted after a severe traumatic brain injury. Due to refractory intracranial hypertension he is intubated and receiving 20mg an hour of morphine, 20mg an hour of midazolam and 200mg an hour of propofol.
A 30 year old male presents with a 3 day history of fevers and increasing breathlessness. On presentation he is noted to be severely hypoxic with sats of 80% on room air. The following chest X-ray is obtained: