The following chest x-ray is from a child with cough & fever. What can be seen? Continue reading
Category Archives: Advanced EM Cases
Intensive Ambulance-Delivered Blood Pressure Reduction in Hyperacute Stroke.
Intensive Ambulance-Delivered Blood- Pressure Reduction in Hyperacute Stroke Li, Y. Lin, J. Yang, C.S. Anderson, C. Chen, F. Liu, L. Billot, Q. Li, X. Chen, X. Liu, X. Ren, C. Zhang, P. Xu, L. Wu, F. Wang, D. Qiu, M. Jiang, Y. Peng, C. Li, Y. Huang, X. Zhao, J. Liang, Y. Wang, X. Wu, Xiaoyun Xu, G. Chen, D. Huang, Y. Zhang, L. Zuo, G. Ma, Y. Yang, J. Hao, Xiahong Xu, X. Xiong, Y. Tang, Y. Guo, J. Yu, S. Li, S. He, F. Mao, Q. Tan, S. Tan, N. Yu, R. Xu, M. Sun, B. Li, J. Guo, L. Liu, H. Liu, M. Ouyang, L. Si, H. Arima, P.M. Bath, G.A. Ford, T. Robinson, E.C. Sandset, J.L. Saver, N. Sprigg, H.B. van der Worp, and L. Song, for the INTERACT4 investigators* N Engl J Med 2024;390:1862-72. May 16 2024
Background Treatment of acute stroke, before a distinction can be made between ischemic and haemorrhagic types, is challenging. Whether very early blood-pressure control in the ambulance improves outcomes among patients with undifferentiated acute stroke is uncertain
Imaging Case of the Week 597
The chest x-ray is from an adolescent with high fever, productive cough and pleuritic chest pain. What can be seen? Continue reading
Lab case 448 Interpretation
Question 1:
We should consider ascending cholangitis in any patient with fever and features of obstructive jaundice till prove otherwise.
The diagnosis of ascending cholangitis is a clinical diagnosis. Classic Charcot triad of abdominal pain, fever, and jaundice seen only in about 40% of patient.
ECG of the Week – 10th July
The following ECG is from a 74-year-old man with one hour of chest pain. He has no cardiac risk factors and denies any significant medical history.
His observations are as follows: HR 58, BP 133/75, Sats 99% RA, afebrile, RR 20.
Describe and interpret his ECG.
Lab Case 448
75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55. Part of the investigation performed was LFT and it showed the following:
Bilirubin = 101 umol/L (< 16)
Imaging Case of the Week 596
The forearm x-ray is from a child with pain & swelling in the elbow & forearm following a FOOSH injury. Only 1 view could be obtained due to patient being in distress. What can be seen? Continue reading
Lab case 447 interpretation
Question 1:
• Hb = 76 (between 7 and 9.9) = moderate anaemia.
Normal MCH and MCV so we have normochromic anaemia.
• WBC = 1.5 (N = 0.9) = mild leukopenia with moderate neutropenia.
• Platelets = 31 (between 70 and 20) = moderate thrombocytopenia.
ECG of the Week – June 26th
The following ECG is from a 48-year-old man who presented feeling generally unwell and “restless”. He has been suffering from a gastrointestinal illness for the past 4 days.
Interpret his ECG and provide a differential diagnosis for your findings. 
Lab case 447
21 year old girl presented with sudden left sided weakness. Her CT head showed intracerebral haemorrhage. Her full blood picture showed the following: