Education sessions 28th February 2019
Dr. Preeti Alur, emergency registrar kicked off the afternoon’s sessions by presenting the month’s Mortality and Morbidity meeting.
Review of the 2 presented cases illustrated the following points:
Case # 1.
Heterotopic (intrauterine gestation coexisting with an ectopic) pregnancies though rare, are commoner now (1 : 7000- 1 : 900) than understood previously (1 : 30,000). This has an association with the increased number of assisted reproductive techniques.
In a pregnant woman (β-HCG > 5 IU/L) with acute/recurrent pelvic pain and positive bedside US showing free fluid could rule in an ectopic pregnancy. Visualising an intrauterine gestational sac does not exclude the presence of a heterotopic gestation
In this case of sub-massive PE in a morbidly obese man, early recognition of critically ill patient at triage, followed by early risk stratification and diagnosis aided in enlisting early assistance from ICU, who coordinated the definitive care including liaising with Haematology re: thrombolysis.
Following this, our Senior Clinical Nurse Educator Stuart Davidson presented rhythm recognition & approach to bradyarrhythmias at the joint medical and nursing session.
‘DIE’ mnemonic is useful to think of some of the treatable causes of bradyarrhythmias:
- Drugs (Prescription or other)
- Ischaemia (Cardiac)/ Infarct (Cushing reflex)
- Electrolytes (e.g. Hyperkalemia)/Endocrine (hypothyroidism)/Environment (hypothermia)
The next hour was an exciting medical treasure hunt game organised by Dr. Farida Khawaja FACEM to familiarise the registrars with the location and use of unique cardiac equipment in the department. In the form of a game, a lot was learnt. For example,
- DC cardioversion
- Transcutaneous pacing
- Lucas automatic chest compression device. Here’s an instructional video from Westmead hospital presented by Dr. Andrew Coggins FACEM on how to integrate the LUCAS device into ALS algorithms.
The last session of the day was an introduction to basic echocardiography in ED. Stations were supervised by ED and ICU consultants of LGH.
Basic probe manipulation, essential knobology and cardiac window acquisition was practised. Thanks to all the ED consultants (especially Dr. Khawaja who facilitated the day’s teaching program), volunteer models and participants for making this an awesome day.