To scan or not to scan – Dr Mike Gibbons
Ordering of CT brain for trauma without radiology registrar approval – consider whether other imaging is required ie: Cervical spine or facial bones
Consideration of anti-platelet therapy as a risk factor for occurance or increased size of intracranial haemorrhage
Low risk of delayed bleed in anticoagulated patient and bleed may occur up to 2 weeks after initial trauma so admission for repeat scan is not usually indicated
Ensure clear documentation of decision to scan or not to scan and that appropriate discharge instructions are given to patient and carer
HOCM and the bands – Dr Hans Hollerer
Dynamic presentation of HOCM:
Left Ventricular Outflow Tract obstruction
Mitral regurgitation
Diastolic dysfunction
Arrhythmias
LVH
“dagger-like” Q waves in lateral and inferior leads
atrial enlargement
atrial tachycardias – AF, SVT
Treatment of collapse in HOCM:
Increase PRELOAD and AFTERLOAD
IV fluids
elevate legs
IV b-blocker
NOTE: Metaraminol contraindicated in structural heart disease
Other key points:
- Tamiflu – reduces symptoms by 3 days, indicated in first 48 hours in some populations
- “Band forms” on blood film – white cell progenitors pushed out of bone marrow, indication of early stages of sepsis
- “The blue book” – communicable diseases, incubation, notifiable illnesses
“It is in moments of decision that your
destiny is shaped”
Decision Making – Dr David Mai
heuristics and metacognitioncroskerry - cognitive forcing strategies (1)
croskerry - cognitive debiasing 2
croskerry achieving quality in decision making
croskerry - cognitive forcing strategies