The following chest x-ray is from an elderly patient post syncope. What can be seen? Continue reading
Category Archives: Advanced EM Cases
ECG of the Week – March 13th 2024
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The following ECG was taken from a 36-year-old marathon runner presenting to the ED with acute gastroenteritis.
He was completely asymptomatic at the time the ECGs were taken, with normal blood pressure and no chest pain, palpitations or dizziness. Electrolytes were normal.  Continue reading
Lab case 440
80-year-old lady presented with confusion. Her Venous blood gases showed the following:
PH = 7.396
pCO2 = 52 mmHg
Lab case 439 Interpretation
Question 1:
PH = 7.30 that is mild acidaemia.
HCO3 = 16 mmol/L (>24) so we have metabolic acidosis.
Next, we need to calculate the anion gap and the compensation (using Winter’s formula)
Imaging Case of the Week 585
The following ankle x-ray is from a 13 year old with severe ankle pain & swelling post twisting injury to the ankle. What can be observed? Continue reading
ECG of the Week – Feb 28th 2024
The following ECG is from a 40-year-old man who presents overnight with left sided sharp chest pain which has woken him from sleep. He describes the pain as radiating into his left arm. He looks well from the end of the bed and his observations are unremarkable.
He has a past medical history which is significant for hypertension, hypercholesterolaemia and a strong family history of ischaemic heart disease.
What are the key abnormalities and how will you manage this patient?
Lab case 439
61-year-old man presented to ED with hypoglycemia that was difficult to correct with oral and IV dextrose. His venous blood gases showed the following.
PH = 7.30
PCO2 = 33 mmol/L
Lab case 438 Interpretation
Answers:
PH = 7.39, that is within normal range/
pCO2 = 48 mmHg, that is slightly elevated (Can be considered normal for venous blood)
HCO3 = 29 mmol/L. That is high (Normal value is 24 mmol/L), SO, we have metabolic alkalosis.
Proton Pump Inhibitor Use and Risk of Serious Infections in Young Children
Proton Pump Inhibitor Use and Risk of Serious Infections in Young Children
Marion Lassalle, PharmD, PhD1; Mahmoud Zureik, MD, PhD1,2; Rosemary Dray-Spira, MD, PhD1
August 14, 2023 doi:10.1001/jamapediatrics.2023.2900 Continue reading
ECG of the Week – 21st February 2024
The following ECG is from a 60 year old lady with chest pain and dyspnoea a few hours after finishing a triathlon. At the scene she was hypothermic at 32 degrees.
On arrival to ED she has no chest pain but ongoing dyspnoea and her temperature has normalised.
This is her initial ECG, what are the key abnormalities and how will you manage the patient?
With thanks to Dr Lorna Cronin for ECG and answer.