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A dose of Dex?

I have a confession.  For as long as I can remember I have been prescribing a dose of dexamethasone or two for people with acute tonsillo-pharyngitis.  Now, I always thought this was a little bit naughty, not really “the done thing” for a doc who tries to be evidence-based.  But over the years I have […]

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Benzos, back pain, Descartes and depression

This week I got involved in an online debate that started at LITFL’s Socrates and Sophistry section, then spilled over into the less-civilized Twittersphere.  Dr Minh le Cong @rfdsdoc (PHARM podcast) and I got into a bit of a debate about the role of benzodiazepines in acute back pain management.  I took the no, not […]

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Ultrasound for Epidurals… I ask an expert: Dr Mitch

I have had a few readers ask questions about the use of ultrasound for the difficult epidural – usually in the labour ward context, but we sometimes run into this in the OT for combined spinal-epidural blocks.  Now I  love all things ultrasound – but looking at the literature it is tough to get a […]

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Clinical Case 048: We Ask an Epidural Expert

This case is an opportunity for us to learn from an expert.  Epidural analgesia in labour can be rewarding and infuriating.  So I have enlisted the help of Dr Roger Browning – Consultant Anaesthetist at Fremantle and King Edward Memorial Hospitals {tertiary maternity centre in WA}.  I put a few questions to Roger based around […]

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Paracetamol: mostly harmless?

This post was inspired by Colin Parker (the original C. Parker) and the team at EMPEM.org who did a discussion on the recent paper released by the ISAAC group (International Study of Asthma and Allergy in Childhood).  This collaborative of researchers (based in NZ, but internationally reaching – kinda like Dr C. Nickson) has been […]