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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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Consultation Skills: Intro

Consultation Skills – not the most exciting topic in medicine, but these are essential skills we use every day.  I think most doctors learned the basics in Med School, then went into real-world practice, found some approaches that worked and some that didn’t and ‘evolved’ a style.  My guess is that we opt for what […]

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Clinical case 039: Ectopic ectopic – a Gedankenexperiment

This case starts with a bad gas.  This patient arrived ‘in extremis’.  Suspected ectopic transferred in by plane with the following data: Urinary HCG positive Abdominal pain for a few days No urine output for the last 24 hours Hb in the remote clinic was 130 g/l yesterday A 14 second US in ED showed […]

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Shock: Back to basics, beyond the BP

Apologies to the smart ones reading this – but I have been trying to explain this concept to my students for a while – so I thought I would share. Shock: this is defined by hypoperfusion of the tissues resulting in insufficient substrates (oxygen, sugar etc) for aerobic cellular respiration. The good news is that […]

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2011 Guidelines : what’s new in Acute Coronary Syndromes

This is a summary of the new ACS guidelines – hot off the press. Heart, Lung and Circulation has produced the 2011 Addendum to the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand Guidelines for the Management of Acute Coronary Syndromes (ACS) 2006. There are a few new concepts and changes which will effect the […]