Category: Acute Care

Kotahitagna 7

Management of post-partum haemorrhage is encountered not infrequently in rural hospital medicine. Administration of TXA is part of local protocols, cheap, easy to use and widely available. Thanks for this appraisal of the evidence Kotahitagna!...

Salute to the Pōhutukawa and the West Coast.

It’s Christmas. I’m touring the north Island with family in tow.  Blooming pōhutukawa line the Coromandel coastline.  I’m curious about its evolution, uniquely suited to the landscape, shaped by millennia of slow and steady adaptations.  Courageously reaching for the coral sea. The New Zealand Christmas tree.  I wondered how many versions of the Christmas tree...

Time to surgery: Comparison between rural and metropolitan hospitals.

Another great read from Otago Universities LOFP. Researchers compared the length of time to receive surgery, the proportion that receive surgery within national guidelines and the corresponding mortality rates at 30 and 120 days for patients who present to the DHB’s rural hospitals vs Waikato hospital. Patients who presented...

Kotahitanga 6

Another great read from Kotahitanga. Recurrent cellulitis is common cause of repeat admissions to our ward, especially in our fluid overloaded heart failure patients. Thanks S.Beck for the article! Compression therapy reduced incidence of cellulitis recurrence in patients with chronic oedema compared to conservative. 40% recurrence in control group...

Syncope? Think outside the box.

Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It can be classified as neurally mediated (mostly young adults), cardiac, orthostatic, or neurologic. This case of syncope comes from Faseeh Zaidi, a 5th year medical student studying at the University of Auckland 72-year-old female...

CRUSH 3 Gallbladder

Acute Cholecystitis is a common complications of gallstone disease, and a frequent cause of right upper quadrant pain in patients presenting to the emergency department. ED PoCUS has been shown to be similarly accurate to radiology performed ultrasound when the following sonographic features are present. Presence of gallstones plus one...

Kotahitanga 4

We love this months Kotahitanga! No more sniffing geriatric urine, a little more digital adrenaline and a little less gabapentin for back pain. Thanks Kotahitanga....

The agitated patient

Here in Taupo we are fortunate to have regular educational simulations run by our resident ED specialist Dr Jared Bayless. Thanks to Dr Jeremy Webber and Andrew Tattle for workshopping how the agitated patient is cared for in the ED. In an aggressive conflict situation, the best advice is...

Breaking Bad (News)

Delivering bad news in a compassionate way can make this difficult situation easier to cope with for patients, their families and clinicians themselves. Thanks to Hailey and Kendall who helped us workshop these skills at Taupo Hospital. SPIKES The SPIKES model was first published in The Oncologist in 2000 as a...

Kotahitanga 3

This week we debated the management of spontaneous pneumothorax and use of high sensitivity of TnI for syncope patients. Thanks Kotahitanga for continuing to bring the scientific rigour. Does your centre offer high sensitivity TnI for syncope patients?...