Clinical Podcasts, Mastery Lectures and the Latest Literature Reviews.

Welcome to the wonderful world of rashes. This is part one of two parts.

This EM Mastery is actually a quiz on rashes. Try it. Members login to watch the video answers.

Below you will find a series...

This is a great case that highlights how important it is, to know how to check if your ECG lead placement is correct. It also includes a rare case of dextrocardia.

CASE

A 39 yo male presented to...

Up to one third of patients with out-of-hospital cardiac arrest(OHCA) have impaired myocardial contractility and vasodilatation. The mainstay of treatment is either adrenaline or noradrenaline.

...

Dr James Edwards discusses the CLOVER Trial comparing restrictive to more liberal fluid management of hypotension in Sepsis.

Reference

The National Heart, Lung and Blood Institute Prevention and...

Dr Adam Micheal reviews the  2021 Update to the CHEST VTE Treatment Guideline. Stevens SM et al. Chest 2021

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Prof Paul Middleton brings us two practice changing papers

1. Cretinous M A et al. Respiratory Rate: The Neglected Vital Sign. MJA 2008;188: 657-659
2. Garcia-Alvarez M et al. Sepsis-associated...

A 68 yo patient is brought into the ED, post cardiac arrest.

The patient collapsed whilst out. Down-time was approximately 5 minutes; bystander CPR was commenced. ROSC was present when the...

The GARFIELD-AF tool allows a single calculation for mortality, stroke and bleeding and can assist in risk/benefit decision-making.

The GARFIELD-AF(Global Anticoagulant Registry in the...

An 88 yo patient who is fully independent, is brought into ED by ambulance in Cardiogenic Shock. The only past history the patient has is hypertension and hypercholesterolaemia.

Earlier that...

In this podcast we go on the patient journey, of a 61 yo patient who presents at 11pm at night with an irregularly irregular pulse, at a rate of 167 bpm and a complaint of palpitations.

How do you...

When I cardiovert AF, I use the highest energy possible energy in the first cardioversion attempt. I consider this to be a resistant arrhythmia and want to have the best chance of...

You might ask; "Why's is subclinical Atrial fibrillation important?" We know that patients in atrial fibrillation(AF) have a 5 x risk of stroke compared to those not in AF and that even short...

When cardioverting patients in new atrial fibrillation, we want our first attempt to be our best attempt. 

The EPIC Trial(1) (Electrode Position In cardioverting Atrial Fibrillation) helps us...

Atrial Fibrillation is the most common arrhythmia we see. Conversion to sinus rhythm of recent-onset of atrial fibrillation is proven to be safe. How do you cardiovert? Is a pharmacological...

Here we review the RACE7 ACWAS (Rate Control vs Cardioversion Trial7-Acute Cardioversion versus Wait and See) Trial (1).

What they did

This was a multicenter, randomised, open label,...

Does a normal ECG exclude Hyperkalaemia?
Do we treat patients with a K+ < 6.5 mmol/L?
Do ECG changes in hyperkalaemia predict a adverse outcome?
Should we treat patients with hyperkalaemia and...

Patients with subclinical atrial fibrillation, detected by implantable devices, have an increased stroke risk, although not as great as that of patient with clinical atrial fibrillation. I also...

The first thing you might say is, "Why's should I care about subclinical Atrial Fibrillation, I work in Emergency Medicine?" Perhaps, this will guide us to making better decisions on...

Emergency airway management and specifically intubation can be associated with significant adverse events, related to the airway itself (failed intubation, oesophageal intubation and hypoxia being...

Open Access article.
A 78 yo patients presents with tachycardia and hypotension. There has been a recent episode of dysuria and the diagnosis of urosepsis is made. Antibiotics are given as you give...

This papercut comes from an editorial in Resuscitation, where they chose four important multi centre RCTs with large sample sizes, published in 2023.... and not necessarily in their journal.

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Emergency airway management and specifically intubation can be associated with significant adverse events, related to the airway itself (failed intubation, oesophageal intubation and hypoxia being...

Mortality in elderly patients with cariogenic shock is high... in some studies, greater than 75%. This review is of an AHA Scientific Statement  Circulation. 2024;149:e1051–e1065
...

Vasopressin is often used as a second line agent to Noradrenaline in septic shock. The usual approach to sepsis is commencement of fluids and if a mean arterial pressure (MAP) >65, is not...