Just trying this out 🙂

Some useful medical score type calculator links aggregated here

Our Department is trialling one of these at the moment for use in cardiac arrests. It is a bit of a faff to get in position and get going but excellent when it does. I suspect it is only a matter of time before this type of device works its way into the pre-hospital phase with our local ambulance service.

Autopulse

Another very useful medical education site that is extremely simple to join and add content to. I will be using work here towards my CPD targets 🙂

GMEP

Good Emergency Medicine site based ‘down under’

One recent article managed to trigger a GMC educational visit to our Department/Trainees 🙁

Useful learning point is how your Hospital needs to adapt to managing staff using social media

Interesting case this morning – abdominal stab wound

Standard ATLS/Surgical dogma is penetrating abdominal injury = absolute indication for laparotomy. However a bit of searching pubmed et al suggests a significant proportion of these type of injuries *could* be managed by expectant observation in a HDU type setting rather than by rushing to theatre. Much depends on local availability of FAST/CT/surgical experience, but it is interesting that penetrating abdominal trauma does not always sine non qua a laparotomy. There appear to be many papers on this so go google……

We had an interesting case yesterday where the ECG looked classically like Wellens Syndrome . Scary thing about this condition is that if the patient is experiencing acute ischaemia the ECG can pseudonormailse – see the with and without pain ECGs here

Learning tips are to watch for the distinctive ECG pattern as described in the links above and also remember you can NEVER have too many ECGs done on a patient 🙂

Great medical educational website at BroomeDocs.com

If you have never heard of Broome use google maps to find it in Australia and see how remote it actually is

Well worth a read through some of the things they deal with far far away from what most of us consider civilisation.

Ten Zulus Buggered My Cat
Easy way to remember the five branches of the facial nerve from superior to inferior

T emporal
Z ygomatic
B uccal
M andibular
C ervical

I recently had a patient sent from the GP surgery with a letter stating ‘widespread t-wave changes ? MI’. I looked at the ECG for a few seconds then realised what was wrong – limb lead reversal. Here is an example (not my patient) of left/right lead swappage There are other ECGs to see at ECG Pedia which show other combinations of lead reversal. Remember to look at the precordial leads too – if the QRS complexes get smaller as you go towards v6, positive QRS in aVR and negative QRS in aVL you could have bagged yourself an ECG in a dextrocardic person 🙂