Week 4.1 – Chest Pain Emergencies
This week we explore the variety of chest pain emergencies that present to our Emergency Department via ambulance, dinghy, helicopter or even sometimes by bicycle. Taking a targeted chest pain history and performing an efficient examination is a skill that develops over time. This skill is essential, particularly in...
Week 3.1 – Airway
This week we get acquainted with airways. Airway almost always comes before breathing and circulation in the life support algorithm, for good reason. Being able to assess and manage an airway is a core critical skill for an emergency doctor. The first excellent post to read today relates to...
Week 2.1 – Anaphylaxis
This week we covered the important and life saving treatment of anaphylaxis. There are no tricks, the answer is adrenaline. Know your doses, know your adrenaline dilutions and know what to do next. Important readings for this week are below. Anaphylaxis: Anaphylaxis Anaphylaxis in children: https://www.rch.org.au/clinicalguide/guideline_index/Anaphylaxis/ Pediatric Anaphylaxis Lastly...
Week 1.1 – Vascular Access
Establishing vascular access urgently in the emergency department can be critical and life saving. This week we discuss and practice the variety of ways you may establish access in urgent and non-urgent situations (including peripheral intravenous cannulas, rapid infusion catheters, intraosseous and central venous catheters/PICC lines). Can’t get IV...
Week 1.0 – Welcome to the ED Teaching Program
The Island Docs ED Teaching program occurs twice a week at flexible times to suit our ED resident, medical students and the SMO. Teaching sessions are a two way learning process for our juniors and seniors. As we will not even begin to cover the essentials of emergency medicine in these...
Q. Is bed rest an effective treatment for anything?
Meta-analysis on 39 randomised control trials for 15 different conditions (5777 patients) Following a medical procedure: Out 24 RCTs-No outcomes improved significantly 8 worsened significantly in some procedures Lumbar puncture – vertigo, nausea and vomiting (no significant improvement in headache) Spinal anaesthesia – headache, back pain Radiculography – headache,...
Even Short-term Oral Steroids Carry Serious Risk
Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1415 (Published 12 April 2017)Cite this as: BMJ 2017;357:j1415 Cohort study of more than 1.5 million adults 30 days of initiating these drugs, even at relatively low...
Smoking cessation: Is abrupt quitting more effective than a gradual approach?
Lindson-Hawley N, Banting M, West R, Michie S, Shinkins B, Aveyard P. Gradual versus abrupt smoking cessation. A randomized, controlled noninferiority trial. Ann Intern Med 2016;164(9):585-592. Patients in the “abrupt cessation group” were asked to stop smoking on their quit day. Participants in the “gradual cessation group” were also...
What is the best duration for nicotine replacement therapy?
525 smokers enrolled. Randomized groups for nicotine replacement via patch at 8, 24, 52 weeks 6 month cessation rates were significantly higher if patches used for 24 wks. vs 8 wks. No adverse effects noted Cost effective benefit long term. No additional therapeutic advantage with long term treatment...
POEM 16.03.17
Q. How do I treat resistant Mycoplasma Genitalium? Management of Mycoplasma genitalium infections – can we hit a moving target? BMC Infect Dis. 2015 Review and meta-analysis of 19 studies Azithromycin standard single dose failure (40%) No randomised controlled trial has compared azithromycin 1 g single dose with extended azithromycin...