Bell’s palsy

Last Updated on February 25, 2019 by FRCEM Intermediate Bell’s palsy: Acute idiopathic unilateral paralysis of the facial nerve. Etiology is most commonly vascular, inflammatory or viral. Risk factors include pregnancy, obesity, hypertension and diabetes Signs/Symptoms Drooping of the eyelid or an inability to completely close the eye Drooping of […]

Acute limb ischaemia

Last Updated on February 24, 2019 by FRCEM IntermediateEtiology Left atrial embolic thrombus from atrial fibrillation Mural thrombus after myocardial infarction, Thrombus or emboli from abnormal or prosthetic heart valves Emboli (thrombus or atherosclerotic) from an arterial aneurysm (aorta, femoral, or poplite) Proximal atheromatous stenosis Trauma Iatrogenic Intra-arterial drug use […]

Myotome and dermatome

Last Updated on February 24, 2019 by FRCEM IntermediateThe list below details which movement is most strongly associated with each myotome: C5 – Elbow flexion C6 – Wrist extension C7 – Elbow extension C8 – Finger flexion T1 – Finger abduction L2 – Hip flexion L3 – Knee extension L4 – Ankle […]

Rapid Sequence Intubation

Last Updated on February 24, 2019 by FRCEM IntermediateIndications A – airway protection and patency B – respiratory failure (hypercapnic or hypoxic), increase FRC, decrease WOB, secretion management/ pulmonary toilet, to facilitate bronchoscopy C – minimise oxygen consumption and optimize oxygen delivery (e.g. sepsis) D – unresponsive to pain, terminate […]

Interpretation of Rinne’s and Weber’s tests

Last Updated on February 23, 2019 by FRCEM Intermediate Test Normal Conductive Hearing Loss Sensorineural Hearing Loss Rinne’s Air louder than Bone (Rinne’s Positive) Bone louder than Air (Rinne’s Negative) Air louder than Bone (Rinne’s false positive) Weber’s Sound heard in midline Sound heard in bad ear Sound heard in […]

COPD

Last Updated on February 23, 2019 by FRCEM IntermediateTreatment  Controlled oxygen therapy to maintain SaO2 88-92% Nebulised salbutamol 2.5-5 mg Nebulised Ipratropium 500 micrograms Prednisolone 30 mg Antibiotic agent (when indicated) Indications for NIV include: pH <7.35 and a PaCO2 >6kPa or 45mmHg Severe dyspnea with clinical signs suggestive of […]

Large Joint Examination

Last Updated on February 23, 2019 by FRCEM IntermediateKnee Injury Mechanism of Injury PCL Injury: Anterior force applied to the proximal tibia with the knee in flexion (e.g., when the knee hits the dashboard in an automobile accident). ACL: Quick stops and sharp cuts or turns create significant deceleration forces […]

Pediatric resuscitation

Last Updated on February 21, 2019 by FRCEM IntermediateCalculations Pediatric resuscitation – BLS   Infant and child BLS sequence Differ from adults Give 5 initial rescue breaths before starting chest compression. If you are on your own, perform CPR for 1 min before going for help. Compress the chest by […]