probe prevents probe…
Recently, a colleague of mine was wanting to perform a diagnostic tap on a patient with cough, fever and a CXR suggesting a left sided pleural effusion…. I was asked to perform a bedside USS to mark out the safest…
a troublesome tachycardia
The Case. An 11 year old boy is bought to ED by his mother on a busy weekday evening. Mum reports that he has been ‘a little bit off’ over the past 24 hours, in particular he’s not keeping down…
big black spider…
The Case. A sunny Saturday morning in Sydney and your 56 year old patient was just outside doing some gardening when they feel a rather sharp bite on their right hand (on webspace between thumb and index finger). He arrives…
R&R In The FASTLANE 028
Research and Reviews (R&R) in the FastLane: experts worldwide tell us what they think is worth reading from emergency medicine and critical care literature
a difficult airway…
The Case. The ‘Batphone’ alerted us of a 68 year old female who is postictal following two seizures in rapid succession. She has a history of ‘a brain tumour’. P 120. BP 176 systolic !! GCS 8 Afebrile. Sats 98%…
another ECG case…
The Case. I was superficially involved in this case of a 32 year old suicidal patient who ingested two full packets of Solian (amisulpride) (~ 24 grams) approximately 90 minutes prior to arrival to ED. On initial assessment he was…
slowly, slowly…
Case: 76 year old female, presents with lightheadedness and lethargy. She is complaining of mid-scapular pain & is syncopal at triage. She has cold hands & clammy skin. Systolic BP 70 mmHg. Crackles to mid-zones of her chest. Distended JVP.…
shades of grey…
A few days ago I was looking after a 31/40 gestation restrained passenger from low-speed MVA with a slight seatbelt abrasion in her RIF & mild suprapubic pain. She looked well, HR 70 with BP 108 systolic and no features…
generally unwell (part 2)…
For those joining the story for the first time, you can catch up here…. My interpretation of the ECG; Sinus rhythm with 1st degree HB, an ‘odd’ axis. Wide complex QRS (~140-160ms) with symmetrical tall T-waves. ? Hyperkalaemia. Needs urgent…
generally unwell…
The setting: Busy Saturday morning shift. Lots on the go as usual… You sit for a moment to catch up on your notes and review patient results… A nurse hands you this ECG to sign-off saying, “this lady is generally…
more than man-flu (part2)…
Here is the follow-up to the story of our 19 year old febrile patient….. The case continues… His CXR demonstrates the following …. Clear lung fields No pneumonia No CCF is that a ‘globular heart’ ?? This is his ECG……
more than man-flu…
The case: 19 year old male who presented as ‘lethargic & generally unwell’ is wheeled into resus. He is so weak it takes 2 staff and his father to lift him from the wheelchair to our stretcher. He looks horrible.…