Renal Emergencies


Dr Debajyoti M. Roy is a renal physician at Changi General Hospital and he's kindly given us permission to cast his talk on renal emergencies in the ED. A tour de force on balanced solutions, practical management, differences between AKI/CKD & dialysis complications.

Differntiate pleural effusions on CT!

Great video by Medmastery. Learnt so much and hope you do too. Support their channel and view their other great meducation posts.  


Practicalities of transport - small adult edition!

 A talk on the principles of transporting paediatric patients for the STACC virtual conference in May 2021. The principles are extrapolated from experience in retrieval, ED & critical care and can be applied to adults and intra hospital movement as well.  


 

OMI - God!

This is a recorded zoom talk from the EM Sling online conference in December 2020. Different times call for a different style of conferencing for a topic in which you can make a difference. 

Ever think that patient with a subtle TWI in AVL could have been “cathed” earlier? Is it always 2mm elevations or will something less do? Can you convince anyone that a deWinters wave is trouble brewing?

If so, then maybe you are a growing part of the EM populace which thinks that STEMI or NSTEMI doesn’t quite cut it as a sole paradigm for coronary intervention.

Heretic or convert or something in between… I offer no miracles - only perspectives.


Other links on this topic:

The Great Disruptor: Covid-19

Covid-19 will be long remembered by this generation. This low lethality but high impact event has left a scar not only on medical fields but theplanet itself. Thoough suffering from a second wave currently, Singapore has a well documented way of dealing with this and our ED/hospital "positives" can be summarised into:
  • Good command and control from the beginning
  • One source of Information/dissemination + Updated info passed onto the floor daily
  • Swab & Go protocols 
  • Segregation of fever & non fever areas in the ED
    • Fever area - PPE is gown / gloves /N95 / face goggles or shield
    • Resus - PPE is N95 / gloves
    • Resus (intubating and arrests) - PAPR with N95
    • Non fever areas - Surgical mask and gloves

Other good resources:

The original article of the index cases

Handbook by Chinese hospitals

Covid calculators

Johns Hopkins datacentre


Probably the best video you can get on the subject is this detailed look into the pathophysiology and management by ESICM:




And finally when to ECMO:



Syncope guide 2019

A new guide on our site on Syncope! Often overly investigated and common pitfalls abound.

See our guide section here - https://singem.blogspot.com/p/downloads.html

Link is here for pdf.

Comments and edits of course welcome.




Nul pointes..... the zero point survey?

Cliff Reid surmises that preparing yourself BEFORE the stress and immediacy of critical care tasks. Zen achieved via zero points...  survey that is.
Not just for pre-hospital teams but also for ED situations.