This week’s we look at:
- The Child Who Would Not Stop Seizing: Listen to our New ‘Minutes to Clinical Mastery‘ Series on the management of a 7 year old who would not stop seizing.
- Not Another Wide Complex Tachycardia. Yes. Can you work out if it’s VT or SVT? See what the patient had when they reverted.
- A patient with a dusky blue leg. What the diagnosis?
- Hypertensive Emergencies. Dissection, STEMI, Intracranial Bleed and Stroke. We get down to a single drug that we can use for most cases. Listen to the new EMCORE Podcast.
- EMCORE London and Fiji will be incredible next year. Seats are filling now.
THE CHILD WHO WOULD NOT STOP SEIZING: STATUS EPILEPTICUS
A 7 yo child is brought in by ambulance after having tonic clonic seizures that morning. The whole family had been travelling for a holiday. Her mother tried to wake her in the morning, but she was not responding much, so left her sleep a little longer. Approximately one hour later she was found to be having a tonic clonic seizure. The Ambulance were called.
The child has no past medical history although her siblings have had recent viral symptoms. Paramedics have treated with 5 mg Midazolam IM and the tonic-clonic component of the seizure appears to have settled. However this child continues to have seizures despite all treatment.
What do we do next? What is the most likely cause?
Watch the video to find out what happened or read the full blog.
For the Fellowship and OSCE candidates: This is a frequently asked question in the exams.
NOT ANOTHER WIDE COMPLEX TACHYCARDIA. YES ONE WITH A TWIST!
A 45 yo male is brought in by ambulance. They have been called as the patient, who is well otherwise, with no past medical history, has had palpitations. On arrival, the patient is alert, well looking and haemodynamically stable. The following trace is obtained.
Is this VT or SVT with Abberancy or sinus tachycardia with a block?
What would you do for this patient?
This was one with a twist. Decide on the rhythm strip below and then see the post reversion ecg for the diagnosis on ECG of the WEEK.
A PATIENT WITH A BLUE LEG: ONE FROM OUR VAULT.
A 35 yo woman presents with a painful blue swollen leg, that occurred rapidly, the evening before. There is little relevant past history and the patient is on the oral contraceptive pill.
Examination reveals a dusky, blue left leg, that is swollen in comparison to the other side. Pulses are present and the patient in neurologically intact.
An ultrasound is performed and demonstrates an occlusive DVT that extends through the whole limb. It extends into the left common iliac, external iliac, common femoral and superficial femoral veins, as well as into the popliteal vein, extending into the calf.
Diagnosis: Phlegmasia Cerulean Dolens
Read more here.
HYPERTENSIVE EMERGENCIES: THE PODCAST
Listen to the latest podcast on Hypertensive Emergencies, recorded at EMCORE Fiji this year.
How quickly do we decrease systolic blood pressure. What’s the best approach for Dissection, STEMI, Intracranial Haemorrhage and Stroke? Is there one medication that we can use for all?
Available at APPLE PODCASTS and SPOTIFY.
SEE YOU AT EMCORE
That’s all I’ve got for you this week. Enjoy and see you soon at EMCORE
Peter Kas
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