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%…
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.…
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…
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.…
observing the occult…
The case: A motorcyclist is minding his own business, stationary at a set of lights and is rear-ended by a car at ~60-70km He is thrown 10 meters or so from his bike and lands on his left side. Remarkably…
a tonne of bricks…
… well it wasn’t really a tonne; more like a dozen or so individual bricks falling from a height of 3-4 metres that peppered and glanced a patient I saw 48 hours ago. Whilst he presented as a ‘trauma’ and…
just a tablespoon…
This is the story of a 59 year old man who presented to our ED with a complaint of haemoptysis. He is otherwise well, takes no regular medications and besides his ’50 per day’ smoking history (over 40-odd years) he…
The audacity of FOAMed
Mike Cadogan raising a glass to the audacity of FOAMed. Image created by underneathEM.com author Domhnall Brannigan (after Shepard Fairey and commissioned by Chris Nickson). Mike has just written an explanatory piece on the birth of FOAMed on LITFL.com here.