Category: historical

Quidditch – August 2018

Purple Rain (back to front; L-R):

Jason Kollios, Neill Aitken, David Swetman, Phil Naidoo

Kesh Khullar, Kajal Patel, Scott Ilgoutz, Rebecca Lapsley, Gemma Philpott, An Le


Sunshine Squibs (back to front; L-R):

Michael Coulton, Mike Gibbons (obscuro hex), Rahul Bhattacharjee, Elliot Adamson, Sam Law, Faraz Ahmad

Jess Roberts, Rachel Lind, Su Pham, Lucy Selleck (obscuro hex)

Simulation Olympics 2016

UPDATED 9/3/17 – See Dr Neil Long’s additional notes regarding the stations below

On the 14th December ED Consultant Dr David Alexander and simulation registrar Dr Neil Long staged the annual simulation olympics with this year’s event  – “the Pentathlon” – featuring resuscitation stations such as “the swimmer”, “the runner”, “the fencer”, “the shooter” and “the rider”.

Congratulations to registrars Gordon Carter and Mark Daley representing “the Republic of Ireland” who stormed home for the gold medal.


Thanks to all the registrars who came and participated.

[L-R: Sze-Chi + Jess, Son + Kiri, Sheri + Jamie, Rob + Annie, Emily + Maddy, Heather + Ben]

Thanks to Dr Luigi Marino, Dr Raj Patel, Dr Sam Robertson and the simulation centre staff for their help running the morning.




Wolff-Parkinson-White Syndrome with Atrial Fibrillation

• Very rapid irregularly irregular tachycardia (rates may approach 300 beats/min) with wide QRS complexes that vary in morphology
• Often misdiagnosed as SVT, VT or atrial fibrillation with BBB
• Misdiagnosis and treatment with AVN blockers can be deadly!
• Treat with procainamide, flecainide (?), or preferably electrical cardioversion
• Key Point: Avoid all AV Nodal blockers
• Adenosine
• Beta-blockers
• Calcium channel blockers
• Digoxin
• Amiodarone
Pitfall: Treatment with Amiodarone results in patient decompensation (see references)
Take Home Points:
WPW + Atrial Fibrillation
• Irregularly irregular tachycardia
• Complexes vary in shape and width
• May approach 250-300 bpm or higher
• Avoid all AV nodal blockers…including Amiodarone!
• Use Procainamide, Flecainide (?),or electrical cardioversion

Traumatic Cardiac Arrest Algorithm from the European Resuscitation Council

Main changes:
  1. don’t do CPR
  2. control catastrophic haemorrhage
  3. control the airway
  4. bilateral chest decompressions
  5. relieve cardiac tamponade
  6. consider prox aortic compression
  7. MTP
  8. CPR can commence once the chest procedures have been completed but in the context of trauma and hemorrhagic loss your CPR will be useless if you don’t correct the underlying cause.

Heat Stroke

Heat Stroke


Shoulder dystocia

Video coming soon


Joseph Epstein

Some current registrars may not have had the privilege of working with the retiring Professor Joe Epstein, whose professional and personal legacy is deeply woven into the history of both Western Health and the Australasian College of Emergency Medicine. He was presented with a tribute book of anecdotes from family and colleagues at a recent farewell dinner. His presence in the department will be missed.


Western Health ED visits Adult Retrieval Victoria

On the 6th of January 2016, as part of Wednesday training,  the registrars participated in a field trip to ARV, at its current location at Essendon Fields (co-located with Air Ambulance Victoria). The purpose of this teaching session was to highlight other aspects of the state’s critical care system. The visit included a guided tour or the base and aircraft, case presentations and interactive scenario training.

At some point in your careers as ED physicians, you will be involved with a retrieval service, either referring, receiving or as a retrievalists. Consultant Emergency Physicians at Western Health who have previously worked for/currently work for ARV include:

Hans Hollerer, Ruth Hew, Stacy Turner, Mark Dent, Lucia Le-Kim, Andy Tagg, Terence Yuen.

Others have worked with organisations such as Careflight  (retrievalists and coordinators):

Martin Bicket, Karen Robins-Browne.

ARV is currently accredited as a Specialised Skill rotation for 6 months with ACEM and ANZCA.

Many thanks to the Education lead (Dr Daniel Crompton), Education Advisors (Dr Tim Gray and Toni Moylan), Clinical Lead (Dr Charlotte Evans), Retrievalists (Dr Michael Ashbolt and Dr Ying Chen), Flight MICA Paramedic (Toby St Clair), Director (Dr Marcus Kennedy) and administrative assistants (Tanya Kennedy and Janelle Crawford), for making this an enjoyable and highly educational experience.

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