Most Recent

  • Hypotension in Trauma: Is the bar set too low?

    Hypotension in Trauma: Is the bar set too low?

    Trauma is a big killer, and practice has evolved to accept lower blood pressure with the concept of permissive hypotension. In this, the first TiCME Chat session, Dr David Lamond a retrieval and ED specialist and I discuss what traumatic hypotension actually means and what the evidence can tell us about current practices.  What do you think? Post  a comment or question below! We will cover the concepts of permissive hypotension, damage control resuscitation and haemostatic resuscitation in the next tutorial.

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  • 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

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  • 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??


    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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