Medicina d’Emergenza Diagnosi e trattamento
Brown A.F.T., Cadogan M.D.
La quinta edizione di questo manuale, un vero successo internazionale, è stata completamente aggiornata ed ampliata, con l’intento di includere le più recenti linee guida basate sull’evidenza in medicina di urgenza e di emergenza. Il testo segue un approccio standard, chiaro e ben organizzato, concepito per esaltare la [...]
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Yottalook is free radiology-centric web search engine and was designed to provide the practicing radiologists with the most important and relevant information at the time of patient care. The search engine is based on natural query analysis, semantic ontology and ranking algorithms powered by iVirtuoso. The thesaurus of medical terminologies is supported by the Radiology Society of North [...]
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Health Sciences Online (HSO) has launched claiming to be a ‘virtual learning center’ which aims to deliver authoritative, comprehensive, free, and ad-free health sciences knowledge using the search technology of Vivisimo. HSO (www.hso.info) is a portal with browse and search functions with access to a comprehensive collection of top-quality courses and references in medicine, public health, pharmacy, dentistry, nursing, basic sciences, [...]
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Congratulations to Anthony (Tony) F T Brown on his new appointment as the first Professor of Emergency Medicine at the University of Queensland, School of Medicine. Professor Brown shares his evidence based critical care lecture series with the wider medical community through this blog.
Prof Anthony F.T. Brown (MB ChB, FRCP, FRCS(Ed), FACEM, FCEM) is a senior [...]
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AFTB lecture notes - Acute Pulmonary Oedema (APO)
DIAGNOSIS
Acute heart failure syndrome (AHFS) spectrum can be divided for therapeutic management into:
Dyspnoea + /- congestion with elevated systolic blood pressure (SBP) >140 mmHg, usually with abrupt onset APO (most frequent type)
Dyspnoea + /- congestion with normal SBP 100-140 mmHg, usually with [...]
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AFTB lecture notes - Aortic Dissection
EPIDEMIOLOGY
Incidence: 3 cases per 100 000 people per year; up to 25% missed diagnosis ante-mortem. ‘Typical’ case 60-80 years old M>F. Overall in-hospital mortality 27%.
Risk factors:
Inherited disease (especially younger patients < 40 yrs) - Marfan’s syndrome (fibrillin gene mutations), Ehlers-Danlos syndrome type IV (collagen defects), Turner syndrome, annulo- [...]
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AFTB lecture notes - Venous Thromboembolism
AETIOLOGY: Venous Thromboembolism
Acute provoking risk factors: hospitalisation, surgery, trauma or fracture of lower limbs or pelvis, immobilisation incl plaster cast, long haul travel, recent oestrogen therapy in last 2 weeks, IV device such as cannula.
Chronic predisposing factors: Inherited: Protein C, S, antithrombin III [...]
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RISK STRATIFICATION OF PATIENTS WITH SUSPECTED AMI
Less than 30% patients currently admitted to CCU have final diagnosis AMI. Conversely 2-5% AMI patients are inadvertently sent home, accounting for 25% of all emergency care malpractice dollars awarded in litigation.
Twenty-five percent AMI patients have atypical symptoms and signs, 50% an initial non-diagnostic ECG. EDs +/- chest pain [...]
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EMERGENCY DEPARTMENT / EARLY MANAGEMENT STEMI or NSTEACS
Targeted clinical examination and 12-lead ECG within 10 minutes.
Oxygen, aspirin 75-325 mg orally (odds reduction in vascular events of 46%), nitrates S/L or IV (unless SBP < 90 mmHg, bradycardia < 50), and adequate parenteral analgesia for everyone.
Reperfusion strategy, for ST elevation or LBBB on ECG presenting within [...]
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MYOCARDIAL INFARCTION / ACUTE CORONARY SYNDROMES (ACS) - Part I
EPIDEMIOLOGY
Over 32,000 deaths per year in Australia: largest single cause.
50% reduction age-adjusted mortality (by risk-factor modification) since 1960, still falling now, but those with chronic CAD are increasing commensurately.
Still 60-70% die prehospital (this proportion unchanged) - thus overall 28-day mortality has improved little, compared with reduced [...]
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