EMDutch Review – Jan 2014

3 Feb

 Presentations and Videos

 EmergencyMedicineIreland

 http://emergencymedicineireland.com/2012/12/anatomy-for-emergency-medicine-023-shoulder-dislocations/

Now you understand why the Cunningham method can be so successful. I already love this method (for the right patients).

Emergency Care Institute New South Wales

 http://www.ecinsw.com.au/LP_video3

Dr Rod Bishop, Emergency Physician, at the 2013 Terrigal EM in Review Conference, looks at evidence for the decisiont to Lumbar Puncture (LP) or not.

Conclusions:

CT before 6 hours after onset of headache 100% sensitivity!!!

CT after 6 hours sensitivity of 87% only. Uncertainty clinically or after 6 hours, discuss LP.

Dr Smith’s ECG Blog

http://hqmeded-ecg.blogspot.nl/2013/11/new-k-wang-video-electrolytes.html?m=1

A 15 minutes presentation about ECG’s in electrolyte abnormalities. “Long QT due to hypocalcemia doesn’t give Torsades.”

Articles

Risk tolerance for the exclusion of potentially life-threatening diseases in the ED.

 http://www.ncbi.nlm.nih.gov/m/pubmed/17543658/

“Guidelines for suspected PE and ACS allow small but nonzero calculated risk end points in low-risk settings, whereas SAH guidelines afford no misses. Because many gold standard tests are more invasive and can have adverse effects, guideline authors should consider adopting a standard acceptable miss rate as an end point for workups with low clinical suspicion to avoid the overuse of invasive testing.”

 

Picture

PE Death Spiral

See you next time and talk to your neurologists about the (often not so) usefulness of LP’s in SAH.

Egon Zwets

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