"While e-cigarettes are believed to be a safer form of 'smoking', this does not equate to safer forms of nicotine". The E-cigarette solutions have mean nicotine concentrations of 8.5–22.2 mg/mL and are sold in 5 to 20 mL vials. Keep in mind that the estimated lethal dose for nicotine in humans is 1 mg/kg.Read More
If you find yourself managing a case of aluminium phosphide poisoning (a common cause of acute pesticide poisoning in developing countries), beware if you're the airway doc, spontaneous ignition has been reported. No Lie.Read More
Risk stratifying hot joints is where we can probably save the most lives in the waiting room. Septic joints have a reported 10-30% mortality and need to be separated from rheumatic, gouty, and traumatic joints.Read More
So a group of EM docs thought it would be fun to see how they compared to the orthopods in the diagnosis and treatment of distal fibular Salter Harris I fractures (SH-1) in a study titled: Consistency between emergency department and orthopedic physicians in the diagnosis and treatment of distal fibular Salter Harris I fractures.Read More
Well, I’ve been hearing a variety of comments thrown around about the optimum management of STEMIs. So, in the spirit of reviewing the basics on this important topic, let’s review the key papers that compare PCI to thrombolytic therapy for AMI.Read More
Welcome to volume 1 of the official unofficial newsletter for the Department of Emergency Medicine at Middlemore Hospital. Our goal is to provide an occasional update on practicing emergency medicine here in New Zealand. Since the ED is such a central multidisciplinary hub of acute care activity, we want to welcome all our colleagues to read and comment on
“The Sharp End”.
We are going to share our ramblings on recent literature, conferences, podcasts, blogs, and other stuff that we can steal and give it back to you to use while you’re in the ED.
In addition to this (hyperlinked) newsletter, we are in the process of creating a website, a blog, a Facebook page, an interactive 3D full-sensory experience that will have you both understanding the confidence intervals and smelling the emesis around each of the papers. There are embedded links in the emailed copy (if you want to be on the mailing list, email us), and we can email you entire papers as well if interested.
We hope this “newsletter” will generate discussion and we look forward to hearing from everyone involved in the ED. Our contact information is on the bottom and we would love to hear from you. We will be posting interesting viewpoints and discussion about previous and future issues on the back of upcoming newsletters. So for now, sit back with a cup of coffee (or beer if you have just finished your shift), and ENJOY- Chip & Andy
Need a sodium bicarb (NaHCO3) drip fast for that TCA OD?. Grab two 500ml bags of D5W (not NS) and three NaHCO3 jets from the antidote cupboard in the monitored area. Squirt one and a half jets in each bag. Presto - A liters worth of normal-tonic NaHCO3 drip.
Need a quick pressor in 15 seconds ? 1 ampule of 1/1000 Adrenaline in liter bag of normal saline. Draw out a 10cc syringe worth and you have 1microgram/ml of adrenaline to push until a drip is started. Remember, start at 2-10 micrograms/min... or 2-10 mLs from the syringe.