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GET FOAMed: Generalist Emergency Training, free meducation

Today I “attended” the first Google Hangout session of the GET FOAMed Rural masterclass. This is a new collaboration between Drs Minh & Shelly le Cong, Tim Leeuwenberg, Michelle Johnson and myself.  We are all doctors with a passion for improving the standard or rural health, with a focus on the acute care.  The catch […]

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PHARM Podcast: the 4 Resusciteers

Had a great day doing all sorts of teaching, clinical conundrums and great medicine.  Started with septic joints, gout and pus, ended with a DC cardioversion and more pus! Highlight of the day though was a chat I had over the ether with 3 other Australian Docs: Minh le Cong (PHARM), Michelle Johnson (LITFL) and […]

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Should Normal saline be the norm?

Here is my observation of clinical practice in most places I have worked in Australia. The doctors use normal (0.9%) saline as a default fluid for most situations.  It is recommended by all the resuscitation algorithms as the first line and whenever an intern charts some fluid – you can bet that 90% of the […]

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Clinical Case 036: Silent, sitting sepsis

This case is part of my “Sepsis week” at Broome Docs.  Lets say this case happpens in January, just after the first big rain for the wet season. 58 yo Aboriginal man, presents to triage at ED complaining of “cold sick” [flu] symptoms. Has been feeling hot, sweating and had a non-productive cough intermittently for […]

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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 […]