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Optic nerve sheath diameter: window to the soul?

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Almost exactly 3 years ago I posted an article looking at the utility of ultrasonographic Optic Nerve Sheath Diameter measurement to assess patients for raised intracranial pressure.  That post is here The idea is sound, the optic nerve sheath is an extension of the subarachnoid space – so if ICP goes up it should expand […]

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Clinical Case 095: Smashmouth vs. Surgeon

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Gday, it has been a few weeks since the last clinical case.  Today I have a rural trauma case with a twist.  I have been doing a lot of pondering around logistic and practical matters with regards to managing trauma in a smaller hospital.  I keep getting stuck on a few points – so I […]

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Remote Resuscitation

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Greetings from sunny Cairns, Qld – where I am at the Bedside Critical Care conference. I had a novel experience the other day.  A remote resuscitation of a critically-injured trauma patient.  Not sure what we should call this…. maybe “VR”for  Virtual Resus, Video Resus, Vicarious resus…. We have recently started using a video interface with […]

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Clinical Case 085: the trouble with Phineas

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Imagine this scenario. You turn up to work your day shift and see you have been assigned to the Obs ward for the morning.  It is your task to see the dozen or so patients sleeping off the evils of the night before in the small ward out back of the ED.  You know the […]

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Iodine vs. Chlorhexidine skin prep

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OK it isn’t the biggest or sexiest decision you might make on any day of the working week – but one where there is in fact some evidence.  Betadine  vs. Chlorhexidine – not really a hot debate.  Boring EM at best. Are you making incisions in patients, or are you doing skin lac repairs?  I […]