• Surf…and Heart Failure

    This short video will change the way you understand acute heart failure. It uses the ocean to visually explain how vascular failure is different from chronic heart failure with clear explanations and echo views. Its the follow on and answer  to the real time and real life case . For those wanting to get into more detail, I suggest reading this brilliant article  “The pathophysiology of hypertensive acute heart failure” David Viau, et al. Heart 2015. 101; 1861-7. doi: 10.1136/heartjnl-2015-307461

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  • The TOXIC ECG

    The ECG in toxicology. Cardiac electrophysiology is used to explain how to use the ECG to decide which poison your OD patient has taken, and how to guide treatment.

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  • Video vs Direct laryngoscopy

    A short video explaining the geometry, anatomy and technique differences between the hyperangulated video laryngoscope and the standard direct approach with macintosh blade for intubation. Simple explanations and pictures and lots of specific practice tips to avoid common pitfalls and improve safety and success

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  • ECG number 5: chest pain…again!

    ECG number 5: chest pain…again!

    And now a subtle variation from ECG number 4 A 45 year old male smoker comes with with 1 hour of moderate central chest pain. What are the key features of this ECG? What would you do next? click on ECG to enlarge

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  • Decisions , Errors and Cognition: Part 2, errors

      This continuation from Part 1 uses fascinating non medical examples to describe the errors we make and why. Finish this 3 part series and learn to avoid errors by watching the final video in the series

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  • Introduction

    Introduction

    Welcome to TiCME Time Critical Medical Education is a unique medical education site for all those working or interested in critical care.  TiCME is aiming to add to the huge amount of ‘minute to minute’ update style medical education by providing a framework in which to understand and then learn the knowledge and skills needed for advanced practice.  Lectures are in video format and include large numbers of real clinical examples and novel techniques developed over many years of teaching experience. To […]

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Most Recent

  • Surf…and Heart Failure

    Surf…and Heart Failure

    This short video will change the way you understand acute heart failure. It uses the ocean to visually explain how vascular failure is different from chronic heart failure with clear explanations and echo views. Its the follow on and answer  to the real time and real life case . For those wanting to get into more detail, I suggest reading this brilliant article  “The pathophysiology of hypertensive acute heart failure” David Viau, et al. Heart 2015. 101; 1861-7. doi: 10.1136/heartjnl-2015-307461

    Continue reading »

  • Real Time and Real Life

    Real Time and Real Life

    Here’s a video of a real patient in the first few minutes of arrival in emergency. Information will appear in real time. Each time you are prompted, pause the video and think or write down your best answer. Working rapidly to narrow down your DDx based on limited information is a key skill for the emergency physician – are you up for the challenge??

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  • Cardiac Arrest Assessment

    Cardiac Arrest Assessment

    This short video will show how multiple modalities of assessment can be used to help decision making in cardiac arrest. See more detail on End Tidal CO2 in this tute Having trouble rapidly diagnosing tachycardias? See my narrow complex and wide complex tutorials

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  • Haematology Spot Diagnosis

    Haematology Spot Diagnosis

    A rare clinical sign from Sri Lanka today in this quick case Ill hand you the diagnosis

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  • ECG #9 RVH with or without?

    ECG #9 RVH with or without?

    We saw 2 patients yesterday that both had significant RVH One had chest pain, the other had COPD exacerbation. Can you pick which one had the ischaemia?                       See the ECG#8 here for an infarct hiding in LBBB    

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  • ECG #8  More chest pain!

    ECG #8 More chest pain!

    A 65 yo Male comes in with central chest pain of 1 hour duration What is the diagnosis and what criteria did you use to confirm?  

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  • Takutswhat??

    Takutswhat??

    A case which is a classic presentation of a rare condition – or is it?

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  • Be a clinical detective in a minute!!

    Be a clinical detective in a minute!!

    Watch the signs unfold and see if you can diagnose this common condition

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  • A terrible case of tropical fever

    A terrible case of tropical fever

    Hi everyone, another important and very tragic case from Sri Lanka An adolescent  comes in with fever, abdo pain, vomiting, lethargy and malaise. He had been sick for about 7 days and had been at the local hospital 80 km away for 24 hrs. On presentation he had a BP of 58/25 and a pulse of 65. He had a tender abdomen which was mildly distended a few cervical and inguinal lymph nodes and bibasal crackles. He was given NS resuscitation […]

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  • A curious tachycardia

    A curious tachycardia

    This is a case from Galle, Sri Lanka which shows a very unusual case of a 32 yo lady 3 days post partum who presents with palpitations. What’s unusual is that she can transmit AF and flutter at 1:1 to her ventricles…implying an abnormal connection to her ventricle, not her AV node. Usually a WPW Accessory pathway will lead to at least a few broad complexes as the pre-excitation leads to early ventricular depolarisation and a delta wave /broad complex. […]

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