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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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  • The TOXIC ECG

    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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  • WIDE FAST and SCARY

    WIDE FAST and SCARY

    This tutorial is a mix of various wide complex tachycardias in case based format. It explains some of the major wide fast and scary rhythms and how to differentiate and manage them.

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  • ECG 7: WOBBLY

    ECG 7: WOBBLY

    A 81 yo old lady presents feeling decidedly crook. She feels wobbly on her pins and has fallen over a few times in the least 3 days – thankfully on carpet and she’s uninjured. Her ECG is done and appears below   1. What is the diagnosis? 2. What is your stepwise management assuming the BP is 80/40

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  • ECG week 6 syncope ANSWER

    ECG week 6 syncope ANSWER

              So this ECG is sinus rhythm and has broad complexes with RSR’ in V1 V2 consistent with RBBB. the PR interval is over 200ms (1 big square) so there is a first degree AV block as well. There is also a left axis deviation (V1 up aVF down). In the setting of RBBB and Left axis you should think about left anterior or posterior hemi/fascicular block  (LAFB, LPFB). There are rS complexes in II, III, […]

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  • ECG 6: Syncope

    ECG 6: Syncope

    A 74 year old lady comes in after falling over at the pokies. She’d been scoffing a few shandies and got up for a wee, and was seen to collapse onto the carpet. She was awake a minute or so later and gradually improved by the time she came into the ED. She now looks well Have a squiz at this ECG. Does it help you to build a risk profile or even a cause for her fall??

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  • Video vs Direct laryngoscopy

    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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