Our team discuss the papers from our February 2023 Journal Club: A sepsis theme this month looking at: introduction of an ED pharmacist lead sepsis-alert system; fluid restriction for sepsis on ICU; and peripheral vasoactive administration for paediatric patients with septic shock.
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None of us got into emergency medicine because we love rashes. A wise FACEM once told me, “I only care if it doesn’t blanch, involves their mucous membranes, has massive vesicles or their skin is falling off.”
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Our team discuss the papers from our January 2023 Journal Club: A paediatric theme this month looking at immobilisation of torus fractures, mid-arm point for paediatric ICC insertion, and screen time in paediatric concussion.
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A 30-year old woman presents to your Emergency Department complaining of mild abdominal discomfort and exertional dyspnoea. She feels well and doesn’t particularly want to be in hospital, but was told to present by her fertility team as she had recently had in-vitro fertilisation.
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Our team discuss the papers from our December 2022 Journal Club: The EXACT Trial assessing the effect of lower vs higher O2 Sats targets post ROSC and the DOSEVF Trial assessing Double Sequential External Defibrillation compared to standard debrillation for VF arrest.
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Our Journal Club is back with another three papers this month looking at: The HOLLT study, IV paracetamol vs IV hydromorphone, and fluid resuscitation in pancreatitis.
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It’s a busy Friday night at your regional Emergency Department when a 23-year-old pregnant woman presents with PV bleeding and abdominal pain. She is G1P0, estimating 6/40 by LMP. She saw her GP 4 days ago, with a BHCG 800.
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Unlock the secrets the ACEM Exams
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A 30 year old bricklayer has fallen 3m off scaffolding onto the hard ground below and has been unable to mobilise since the incident. The patient presents complaining of back pain with associated altered motor function and sensation to his lower limbs. He is GCS 15 and his vital signs read a BP 80/40 mmHg, Heart Rate 47bpm, Oxygen Saturations of 100% on room air and his temperature is 37 degrees Celsius. He has warm hands and feet. On examination you notice that power of his lower limbs is 0/5 in all myotomes and he cannot appreciate sensation below the dermatome level of T4.
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It’s 4:20am on a night shift, and you’ve finally caught up with the waiting patient list. Just as you’re thinking about where you could source some caffeine, you see a 26 year old male come up on the screen. The triage note reads: “2/7 epigastric pain, can’t sleep tonight”. You barely get a chance to chart the pink lady when a nurse places a venous gas result in front of you.
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Unlock the secrets the ACEM Exams
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