Upper limb (UL) and especially shoulder injuries are a fairly common presentation within the ED, but in the acute phase can be difficult to give a definitive diagnosis and an appropriate treatment / referral plan.
Category: Learning
Quick-Wee method
Have you ever wanted an infant to PU faster?
Gentle suprapubic cutaneous stimulation with gauze soaked in cold fluid (the Quick-Wee method) led to a clinically and statistically significant increase in voiding and successful urine collection within five minutes for infants aged 1-12 months
An ideal job to be given to parents/carers
Anion Gap & Metabolic Acidosis
The anion gap (AG) represents the amount of unmeasured anions in the plasma.
AG =([Na]+[K]) – ([HCO3]+[Cl])
The main contributor to the AG is albumin (decreasing albumin by 1g/l reduces the AG by 0.25) so hypoalbuminaemia can falsely reduce the AG.
Corrected AG = AG + (0.25*(40-[albumin]))
(However, this relies on getting LFT’s back about 1 hour) Read more
A-a gradient
A-a gradient = Alveolar Oxygen – arterial Oxygen
This is “relatively” simple way of working out if the paO2 on a ABG is normal, and demonstrates V/Q mismatch well. V/Q mismatch is simple terms is either an area of the lung either under ventilated(pneumonia) or under perfused (PE). Read more
Devastating Brain Injury?
Scenario (Not uncommon)
A patient either post arrest or head injury has a CT demonstrating significant brain injury and Leeds says “No”
