
Category: SMS teaching


NEW TROPONIN – OLD TIMI
Thanks to Prof Anne-Maree Kelly for her update on the new troponin assay.
She has provided a flowchart and FAQ below for you to review.
Please also see the TIMI scoring worksheet, for those unfamiliar with the TIMI score.
Hs Trop flow diagram.7 Nov 18 (1)Troponin change FAQ_corrected (1)
TIMI form

SMS: Thinking about paediatrics
Thanks to A/Prof Dr David Krieser for his presentation at Senior Medical Staff teaching in October 2018.
His talk has been broken into 3 parts:
- Don’t Forget the Bubbles recap
2. Paediatric cases and paediatric deaths in ED
3. ED redevelopment and other shortcuts in paeds ED

Coffee and cases – Consultant teaching 22 June 2018
Thanks for attending consultant teaching yesterday.
With my educator’s hat on, staged repetition is the best way to remember, so here are some links to some of the topics we discussed:
Propranolol OD (Justin Curran):
https://lifeinthefastlane.com/toxicology-conundrum-044/
http://www.emdocs.net/wp-content/uploads/2015/08/HighDoseInsulinCCB-Yuan-.pdf
Knee Dislocation (John Loy):
Knee Injury 2018
https://emergencymedicinecases.com/occult-knee-injuries/
Rice Bezoar (Gary Ayton):
Only 1 publication:
https://www.ncbi.nlm.nih.gov/pubmed/?term=rice+bezoar
– you definitely need to write this up!
A good summary:
https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2015/11/Sanders-Jan-04.pdf
Bezoars are apparently highly prized and “ascribed mystical and medicinal powers and considered invaluable
possessions”
Cardiac Tamponade (Stacy Turner):
http://www.ultrasoundpodcast.com/2013/11/pericardial-tamponade-learn-know-foamed/
http://5minsono.com/tamp/
http://resus.me/tag/tamponade/
Thanks.
Stacy
Procedures for consultant education
Hi guys.
Here are some videos relating to the procedures we covered during the consultant education this month.
Enjoy!
Stacy
I-gel 2nd generation supraglottic airway
Surgical Airway – Scalpel
RIC line
MAC line
Humeral IO

SMS Teaching: Traumatic Cardiac Arrest
Here’s the video from March 2018’s consultant education, on the theme of traumatic arrest.
It includes a case discussion of a gunshot wound to the chest in a young women with cardiac arrest, a talk on the management of traumatic arrest and the utility of CPR, and finally a discussion on ED thoracotomy.
The quality’s not great and we lost the AV halfway through, so I’ve patched in a PowerPoint presentation of the second part.
There’s also a video from the Alfred procedures course on thoracotomy- please don’t distribute this further, as it’s released to candidates on the course only.
Hope you enjoy, please post any comments or questions and we’ll attempt to answer them.
Thanks.
Further reading:

SMS teaching: THRIVE trial and Paediatric SVT
Thanks to Dr Martin Bicket
August 2017
(29 min)

SMS teaching: RSI update Aug 17
Thanks to Dr Stacy Turner
August 2017
(43min)

SMS teaching: Pneumothorax
May 2017
Thanks to Dr John Loy
(29min)
Discussion points:
- The majority of large pneumothoraces managed this year have ultimately required intervention
- Non-intervention in one case has also generated further dialogue with the Respiratory unit regarding management of these patients
- An upcoming multi-centre trial co-ordinated via Monash may further inform our practice
- In the meantime discussion with the respiratory or thoracics team on the day regarding large stable pneumothoraces will ensure timely follow-up

SMS teaching: ED point of care ultrasound
May 2017
Thanks to Dr Raj Patel
(40min)
Discussion points:
- ED point of care ultrasound is focused on answering simple yes / no binary questions that help the clinician with management decisions.
- The RUSH protocol is a useful schema for identifying life threats, and can also be remembered using ‘HIMAP‘ – (heart, IVC, Morrison’s, Aorta, pneumothorax)
- Familiarity with ‘normal’ and development of technique can be best achieved by scanning healthy patients
See also:
Brief notes on probe position from the Family Practice Notebook:
Ultrasound resources from Vanderbilt Emergency Medicine
Brief notes on HIMAP from Life in the fast lane
RUSH protocol – Rapid Ultrasound in Shock and Hypotension
(36min)