Lipid emulsion for LAST

19 Oct

Hi all,

We (registrars ED) wanted to know what evidence and recommendations are available about the use of Intralipid for local anesthetic toxicity, so I did some study and put my findings in a PPP, for whom might be interested.

Cheers, Laura



28 Sep

Dear colleagues,

I didn’t post for a long time, due to moving to Australia. But tomorrow I will do a presentation about envenomations in The Northern Territory…. Which is a bit cynical because I’m probably the least experienced in this hospital regarding envenomations. However, I thought it would still be fun to dive into it (there’s a first time for everything) and to share it with you.

Attached the result: my PPP. A lot of slides because I wanted it to be my summary for Evernote also.

Please don’t hesitate to comment if you need to, especially if you happen to know a bit more about these creatures and envenomations.

Cheers, Laura

Envenomations RDH 09.2015

What to do when you break your arm?

16 May

We are two lovely (according to our supervisor) EM-residents from Medical Centre Haaglanden, The Hague and Erasmus MC, Rotterdam, working at the Sint Franciscus Hospital, Rotterdam for a month to increase our ultrasound skills. We expected to perform e-FAST and cardiac ultrasound a lot, but instead our supervisor sent us several times to all those broken bones. The first time I performed an ultrasound, I put up my glasses, but couldn’t see anything except a white line, but my supervisor told me ‘bone is blinding’, so that’s okay!

The following days, we saw a great number of patients with broken bones. Inhabitants in this area are not so steady (not to mention the amount of patients with drug abuse) and fall quite easily apparently, which was great for our ultrasound exposure. Therefore we will show you some beautiful ones (not patients but ultrasound images) below.

Case 1: What will happen when a 7 year old decide to fall from her bike and there is no ultrasound addict available, because he is performing PSA at her with propofol. Fig 1en 2.


Fig 1


Fig 2

An incomplete reposition at the emergency room, followed by reposition at the operating room next morning was the unfortunate result in this case.


12 May

As promised but a bit later: some tips about how to prepare for the AMC multiple choice exam. Other / practical information about the exam you can find on the website The reason I want to share this information is that it worked for me, and I am not a quick learner, do not have an excellent memory and to be honest: I did not even recognise a lot of the basic stuff anymore, which I studied more than 13 years ago. So, it was a challenge for me.

The AMC recommends a few books to study before you sit the exam. The most important two Continue reading


18 Jan

As promised: the first part about trying to get a job in Australia for a longer period of time.

As a Dutch EP, SEH arts KNMG, you are not recognised as a consultant EM in Australia ( The primary reason is that, to be eligible for ‘the specialist pathway’ (, you need to be an overseas qualified specialist, which we are not with our ‘profiel-specialisme’. Our training is not comparable anyway, neither in duration as in content.

From our current position, we can work temporarily in Australia (2 years) as specialist-in-training via the Specialist Pathway (weird but yes!), or Continue reading


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