Critical Care

101 Reflective Lessons from a Year with Sydney HEMS. Part Three: Clinical

This post, detailing my reflections on clinical retrieval medicine, is the third in a series recording my reflections on the past twelve months, which I have spent working for Sydney HEMS in prehospital and retrieval medicine. The first post covers medical…
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Are you PROcalcitonin? St.Emlyn’s goes bug-hunting.

At work the other day, someone mentioned that we could use procalcitonin to distinguish between viral and bacterial infections, particularly in the paediatric population. It was touted as the answer to that age-old question, “should I prescribe antibiotics for this…
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Sugar and Spice…Not All Things Nice

Synthetic Cannabinoid

The use of synthetic cannabinoids is on the rise.  They are dangerous, don’t fit a particular toxidrome, and can require emergent intervention.  They are a nasty phenomenon and this article will hopefully show you why. The Background Novel psychoactive substances…
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JC: Intubate or not intubate? That is the question…

    Clinical scenario: A multi-morbid, elderly patient with renal failure and recently diagnosed hyperkalaemia suffers a cardiac arrest in your busy resuscitation area before you can start appropriate treatment. You start CPR with a fully available team and give instructions…
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The Emergency Department Transfer: Patient, Preparation and People. St.Emlyn’s

Depending on your department the frequency with which you are faced with the need to transfer a critically ill intubated patient may vary but it is something we think all departments face at some point. Common examples might be: The…
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Critically Ill in PED – the Patient Perspective at #smaccMINI #smaccDUB

  One of my favourite sections of the #smaccMINI workshop at #smaccDUB last year was when my Paediatric ED colleague Roisin McNamara from Dublin and I got the chance to speak a young woman called Eimear. Roisin had already spoken about her…
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You Snooze, You Lose? #smaccUS The Child with Altered Consciousness

As a part of the #smaccMINI workshop back in Chicago in 2015, I spoke about the approach to the child with an altered conscious level. The podcast is below along with a brief summary of the talk. The guidance below…
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