Webucation 25/1/14

Web delights this time emanate from paediatrics to radiology and also to myth busting of the highest quality.

• You're too slow kid. - A great morsel on paediatric bradycardia,
• Wrong answer mister - So you think you're good or are you really that good?
• Circular blockers? - Steve Smith asks - have we indeed done the 360 on beta blockade?
• The ketamine brain continuum - you know we couldn't resist this exposition on ketamine... I mean our website name is sort of an homage to dissociatives!
• Stroke Series - Radiology Channel's excellent run down on hypertensive bleeds on CTs
• Is it really necessary to do postural BPs? - Great myth busting orthostatic measuring! Thanks to LITFL for this vid.

• BIphasic what? - Ryan Radecki plays down this over reaction on the overreaction myth.

The last link allows us to give kudos to the internet myth busting crusaders. Nice to know technology is helping us move forward and away from tradition based medicine.

How bad's the block?

Dr Amal Mattu clears the air on the difference between Mobitz and Complete HB.

For more of his videos, go to his UMEM website.

Review: Urinary dysfunction sensitive for cauda equina?

We are starting to see some good research and audits come out by our residents in Emergency Medicine here in Singapore.
We have decided to put these online for everyone's benefit. They will be under our "EBM" heading on the menu.

Here is the 1st of hopefully many reviews. It is done in a BETs style.

Author: Dr Joanna Chan

Abstract

A shortcut review was carried out to establish whether the presence of urinary dysfunction in patients presenting with lower back pain is a sensitive test for the presence of cauda equina syndrome (CES). 274 papers were found using the reported searches, of which 4 presented the best evidence to answer the question posed above. The author, country, date, patient group, study type, key clinical findings on presentation, authors’ conclusion and study weaknesses are tabulated.  It is concluded that self-reported urinary dysfunction is neither sensitive nor specific for CES.

Full review is here.

Ear emergency!

Here's a nice vid on an ear heaematoma by Prof. Larry Mellick.
Rare but crucial diagnosis and treatment. Also great anatomy revision thrown in.



See more of his videos here.

Webucation 4/1/14

Our 1st installment of Webucation this year contains a barrage of trauma, a smattering of cardiology and a torrent of critical care... pun intended.

• The logroll is dead... long live the log roll? - Could you be harming your patient by shifting him needlessly?
• Blocking rib #s - Chris gives us a superb technique for pain control with far less risk
• 3 for 2  - So you think you know knee #s, can you spot all three of them? 
• The value of a goodhistory - Salim the Rebel EM debunks some myths about chest pain history
• Activation stations - Is overactivation an issue, here's maybe why?
• AXR mythology - Does the abdo xray really change your management?

• IVC roundup - Think you've got a handle on preload? Watch the IVC debate rage on at EMCrit.

The last link demonstrates a few things. Firstly, certainly we don't know it all. Next, it is a fine testament to the state of affairs that so many people not only care deeply but are willing to enter the fray on the topic. Lastly, Viva la FOAM as they say!