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PrinciplesResuscitationAnaestheticsMedicineECGXRCTBlood IxOther IxRashPhotoPaedsSxO+GPsychToxEnvironmentalRadiologyLegalClin riskPre & RetrievalDisasterAdmin/ Educ./ ResearchWeek 1H+M - massiveCOPD Ventilator settingsCOPD-drugs/ ventilatorSTEMIH+M Fever returned travellerSTEMI Inf/post/WenkebachABG UE post morph- MAlk/RAc/A-a/ ExHCO3-E Multi.E Multi.OD Carbamazepine Female Flank painFlank painCarbemazepineInformed consentInvoluntary restraintNegligenceWeek 2TriagePaed sedationAortic dissectionA FlutterSC compressionAFlutterCXR- Cancer/LRTICTB A/CSDH VP shuntABG- K+/AG/ ExCO2Sedation Nasal FBPriapismCHI- A/CSDH VP shuntOD K+/? DigDNR orderDAMAWeek 3CVL site choicePleural effusionCerebellar strokeChest pain unitTIMI ScoreVT young CXR traumaCTB Cerebellar infarctPleural aspPaed burns to feet Ingestion-Dishwash powderBurns feetOcular burnFoot bitumen burnHZOSudden LOVEclampsiaDishwashing powderChest inj. FWAPreparationChest pain unitWeek 4Meningococcus prophylaxisAnaphylaxisCerebral SOLSTEMI ANTFoot- LisFrancCTB SOLABG HAGMA /R ac- AG/ A-a/?gapFacial swellingBronchiolitisLisFrancIschaemic legPreeclampsiaDNWWeek 5Near drowning Ventilator settingsPolyarthropathyElectrical alternansElectrical alternansCXR RMB ETTPaed elbow SupracondylarABG- M alk/R alk- AG/ A-a- / AspirinHAGMALimp 3yrNear drowningEpistaxisOrganophosphate Warfarin(Aspirin- ABG only)Near drowningRBS vs FWSWeek 6TTM trauma MxVassopressinSedation for Paed lip lacFebrile neutropaenia CAP- CORB/SMARTCOP/Ab choiceLBBB ? STEMICXR traumaAXR VolvulusRetrograde cystoscopyCT KUB- Renal calculi GSFBE pancytopaeniaE NodosumErythema nodosumLip lac- wound closureRenal calculiMacroscopic haematuriaVolvulusWound closure optionsFall astrideWeek 7Toxic arrest- modificationsCNVII/ Bells palsyPyoderma granulosumAseptic meningitisCLD- decompensationAbdominal paracentesisVT- toxic ingestionCXR pneumomediastinumCSF asepticNec FascPyoderma GangrenosumNAI 3/12 oldNec fascPneumomediastinumDrugs causing VTVF- Arrest modificationsImpaired physicianWeek 8DCR AF- settingsAF- Rx strategyTrifasicular BCXR PTX tensionABG NAGMA- AG/?gap/ Ex CO2/ Ex K+ParaphimosisOpen # dislocation AnkleParaphimosisPTX tensionParacetamolInfo. disclosureCompetenceWeek 9Massive transfusionFailed intubationStatus epilepticusSTEMI INF + RVCXR traumaCTB EDHABG HAGMA- AG/?gap/ Ex CO2/ Ex K+KawasakisEDHTrauma- low BP, massive transfusionEDHAppendicitis GHB(ABG ? Dig)US for AppxCT for AppxRestraintETT +/- pre CHIWeek 10BiPAPCOPD -BiPAPInf STEMI MxPPM FTC/FTSAnkle septic jtPPM + STEMI infPelvic traumaFAST scanABG HAGMA/ R Ac- AG/?gapAnkle aspirationImpetigoEye hyphaemaImpetigoDec GCSPaed SSUTrauma pelvicEye injuryDCIFAST in pelvic traumaSSU/ Paeds SSUWeek 11EscharotomyNeedlestickHIV prophylFebrile neutropaenia (diff to wk6)Bacterial peritonitisSTE aVr LMCA/ TVDCXR cancerABG HAGMA- AG/?gap/ Ex CO2Peritoneal aspirateBurnsAnalgesiaRenal Colic- medical expulsive RxBurns Paed EshcarotomoyCharcoal roleHaemodialysisBJFIrukandjiIx ? renal colicWeek 12Stroke thrombolysisROSIER scaleAnaemia IxHyperkalaemiaK+ 75 bpmPelvic traumaElbow dislocationCT B- strokeABG/U+E- Na AG/ ?gap/ Ex CO2/ A-aAnaemia3/12 SOBAnaemiaPelvic #Stab neckElbow dislocationChemical restraintICEOpen disclosureRefusal of blood productsRestraintInformed consentWeek 13Hypotensive resusCSF analysisCT prior to LPSTEMI inf BPHypercalcaemiaJunctional escapeWrist lunate/ carpus dislocationCT chest traumaU+E/ CMP- Ca++/Se osmoCTG monitoringBullous rashFCMultitraumaTrauma pregnancyTrauma pregnancyMushroomsPan scan in pregnantTransfer trauma- preparationWeek 14Analgesic options in analgesic tolerant ptBrugada syndromeDKA vs HONKHT urgencyOrbital cellulitisNaBrugadaC spineR hip- # pelvis femurU+E CMP- Na- Se osmo/ AG6/52 old VJaundice neonatal# pelvis/ femurC spine injuryWeek 15GBS vs MS CHB MxHaemoptysisAlcohol withdrawalDKA MxWenchebackCHBTalus #CXR FB- oesophagus, trachea, button batteryABG/ U+E/ Glu- HAGMA DKA- AG/ ?gap/ Ex CO2/ A-a/ Cor Na+Finger amputationPain scoresSupracondylar #CXR FB oesophagusTalus#Amputation fingerWeek 16Brooke- Parkland formulaFacial burnsIndications for ETT in burnsFailed intubationCentral vs peripheral vertigoEpiglottitisSTEMI- inf postC spine soft tissueAXR- LBO/SBOWrist- GaleazziFacial burnsIntusussceptionBowel obstructionVaginal D/cSSRIF/E XR in CSIWeek 17Hybrid resuscitationVentilator settings for Paed CHIVT vs SVTAICD indicationsPPM and ? STEMIPVD/ cellulitisProlonged QTAnkle #/ dislocationCT Abdo- splenic ruptureCTB EDHFBE/U+E/LFT/Coags- HELLP syndromeEye hypopyonFeet- PVD/ cellulitisPaed CHI EDHAnkle #/dislocationSpleen traumaFAST scan findingsAnterior uveitisEctopic pregnancyPreeclampsia HELPPLIF painOD QTUS findings in ectopic pregnancyWeek 18Optimising ventilation for chest traumaVentilator settings for asthmaWPW AF MxSAH – gradeWPW N rateCXR trauma # ribs/ contusionCTB SAHABG asthma/obesity- Resp Ac/ Met Ac- AG/ ?gap/ Ex CO2/ A-aNeck stabEye CRVOMeasles Fluid regime for gastroDehydration assessmentOD theophyllineTrauma teamChest traumaNeck stabCRVOTheophyllineWeek 19ExtubationPPM- FTCMalignant HT PhaeochromocytomaPPM- FTCElbow dislocation + med epi.+ rad headCT Neck/chest - Sx emphysemaABG/ U+E- Met alkFournier’s gangreneElectrical burnsElbow dislocElbow dislocFournier’s gangreneDental drill- mediastinitisElectrical burns1st trimester bleeding Se BHCh USElectric shockUS findings of failed pregnancyDistressed parentWeek 20Post arrest TTM VasopressinDifficult airway predictorsConfirmation of ETTElder neglectARFSVC obstructionECG in pregnancy RH strainPaed # femurU+E- Met ac - AG-K+ ARFSVC obstructionI/A drug injectionNAI- # femurI/A drug injectionPE in preg - IxAntihistamineBox jelly fishPE Ix in pregnancyWeek 21NCT PaedC spine #CT orbit- blowout#ABG/U+E/ Urine spot- Met Alk- Pyloric stenosisTENTENPyloric stenosisSVT CSI Steroids in SCI Blowout #Mesenteric ischaemiaAspirinSnake biteIx of mesenteric ischaemiaCSI transferHandover Week 22CN III palsyHorner’s syndSTEMI- Reperfusion choicePredictors for successful reperfusionTransfusion reactionAlcoholic ketoacidosisSTEMI- inf + postFacial XRU+E/LFT- Alcoholic ketoacidosisIIIN palsyHorner’s syndFever no focus- fwt roleBC roleWCC roleGSWFacial #- Lefort classificationPPH (brief)QuetiapineForensic collectionResearch set upReduce time to thrombolysisDrug seekerWeek 23LAMPLA toxicityWPW AFHypercalcaemiaDVTSuperficial thrombophlebitisWPW AFWrist- Colles#Pelvis- pregnantU+E/ LFT/ Ca++- Ca++Retinal detachmentScrotal traumaRheumatic feverLAMP CollesRetinal detachmentTesticular trauma Trauma in pregnancyLA toxicityUS in Superficial thrombophlebitisRostering principlesWeek 24TxA2/ CRASH1/2REBOATrauma induced coagulopathyThromboelastographyThyroid stormK+ replacementMFATAnorexia nervosaHigh pressure injuriesMajor trauma- REBOA/ TICAnorexia nervosaDAMA self harm riskNMSLomotilNOAC reversalNMSAltitude illnessDAMAISBARWeek 25ViolenceAnalgesia in narcotic dependentAnaphylaxis- EPIPEN useUTIPericarditisAnkle #MSU- UTI pregnantEar perichondritisOD FeCHI – NICE guidelinesPerichondritisChondritisAnkle#Pregnant UTIAcute psychosisSz definitionChemical restraintFe paed Wasp, bee, ant scorpionPrivacyPrinciplesResuscitationAnaestheticsMedicineECGXRCTBlood IxOther IxRashPhotoPaedsSxO+GPsychToxEnvironmentalRadiologyLegalClin riskPre & RetrievalDisasterAdmin/ Educ./ ResearchWeek 26\PE Dx ( Wells/ PERC )PE ECG findingsPE CTPA vs VQPE thrombolysisProlonged QT/ TorsadesECG in hypothermiaQT prolongationTorsadesShoulder dislocationPaed lat C spine- Croup U+E/AG/LFT/Lipase- Pancreatitis CroupShoulder dislocationPancreatitisSTI assault / MAPCCBHypothermia rewarmingPE: CXR CTPA vs VQPre-red'n Xr for ? shoulder dislocation Week 27Triage of chest painED thoracotomyHIV illnessesK+ MxVT - drug inducedC spine Vbg- Met Ac/ K+Moderate + severe asthmaMDI useED thoracotomy C spine #Complications of c spine immobilisationGlaucoma HFl Air retrievalHeli vs fixedAceess block- ambulance ramping Week 28CVC Ind./ CI & siteRhabdomyolysisSAH Ottawa ruleSAH- CT alone vs CT+LPWellens SyndromeAcute joint ?septic arthritisArthrocentesis Ind./CICardiac tamponadeStroke ThrombectomyThrombolysis reversalWellens XR R/U GaleazziABG- NAGMA- AG/ ?gap/ Ex CO2 -Rhabdo US Cardiac tamponadeCompartment syndrome Wrist #Toxic seizureCO /HbO2Thrombolysis reversalWeek 29Elder abuseHUSLBBB and STEMILBBB & STEMICXR Paed LLL pneumoniaABG/ U+E- - HAGMA /Se Osmo AG/ ?gap/ Ex CO2/ Calc Osmo/ A-a ETOH poisoning- Bloody D'sHUSCAP dispositionC spine clearance - Canadian C Spine rulesImagingUBHCG interpretationRequest STOP VenlafaxineCSI-XR vs Ct vs MRILimitation to Rx/ NFROrgan donationCompetency/ MinorOpen disclosureCredentialing CVC placementWeek 30PEA post traumaACS risk stratificationEST vs Stress Echo vs NM vs AngioVasculitic rashHepatitisMobitz II 2ndHBKnee XR dislocationLFT- HepatitisVasculitic rashStab chestAcute scrotumAcute scrotum- Epidid vs torsion Chest stabED delivery Delivery packGas inhalation- ammonia, chlorine phosgeneToxic bradycardiaRadiation exposureUS in acute scrotumForensic deathFull Trial 1Based on MMC 2015-1Protocol chemical restraintMTP protocolNeuroprotection- SAHVentilating asthmaEGDT ARISEBurns fluidsIV access optionsAirway equipmentAirway securing optionsETT indications GHBK+ MxPE Dx- Ix rolesIndications for thrombolysisOrbital cellulitisVertigoMeningitis- asepticGBS vs Spinal cordFebrile neutropaeniaAb choiceSAH- BP controlElectrical alternansHZOQuad/CP- dispositionCarer abuseHCMK+ 100bpmElectrical alternans (diff ECG to next)HCMPelvis Wrist perilunateGastric volvulusCTB SAHUE LFT lipaseABG/U+E- HAGMA- AG/ ?gap/ Ex CO2CSF- viralHZOChest FBOrbital cellulitisHZOChest traumaAsthma D/c criteriaLife threateningEpistaxisChest stabPelvic traumaPancreatitisAsc CholangitisNeck traumaProstatitisPerilunate dislocationGastric volvulusPPHChemical restraintToxic Broad QRSDigoxin ECGCharcoal roleHeat stroke(diff to below)CT /US role in pancreatitis US uses in shockLimitation to Rx/ NFRBuilding collapseTriagePrepare EDDevelop protocolApproach to ? abuseUrgent registrar unavailableChemical restraint protocolFull Trail 2Based on DEMT combined QsCardiac arrest in pregnantACLS algorithmHypothermia resusRewarming methodsRelies in resusA & V in pregnant patientOptimisation ICPDifficult Airway predictorsApnoeic oxygenationConfirmation of ETTCapnographyETCO2 O2 sat effectorsAirway risk factorsLAMPEGDTInotrope choiceVentilator setting in CAPSTEMI - BPAngioedemaScabiesCavitating lung lesiontransferAngioedemaPost Thr bleedHIV TBPPM malfunctionMeningococcaemiaCAPSTEMI- Inf + post + CHBDig toxPPM- FTC/FTSC spine #CXR cavitating lesionWrist CollesCTB-Post thr bleedABG/ U+E- met Alk/ resp Alk/ Na - Calc OsmoVBG/ U+E- NAGMA/ HAGMA - AG/ ?gap/ Ex CO2ScabiesFacial traumaCroup/ stridorBoerhaaves syndromeOttawa footLL # MxSpinal shock Cord syndromesFacial traumaColles #Perimortem CSectionPregnant UTIAssess suicide riskLithiumThrombolysis reversalDigoxinHFLHypothermiaDAMACoronerSTEMI transferroad vs rotary vs FWQI cycleKPIsComplaintDeath in DeptTraumatic deathPt flowAccess BlockNEATFull Trial 3Based on MMC 2016-1Major burns fluidsPericardiocentesisHypotensive resuscitation AAAAnalgesia for # femurFluid assessmentOxygen deliveryVBG applicationBiPAP- COPDIndications for ETTKetamine for sedationLaryngospasm RxSIADHCOPDHCMSIADHPPM malfunctionPericardial effusionBloody D's/ IBDSVT PaedPPM- FTSKnee Femur #CXR Pleural effusionCTB ring lesionCT Abdo AAA ruptureVBG/ U+E- met Alk?? AGMA- AG/ ?gap/ Ex CO2ABG/ U+E- HAGMA- AG/ ?gap/ Ex CO2FAST- Subxiphi USHerpetic whitlowEye- keratitisCat biteNeonatal abdoSVTPaed OD CCBPaed Appx scoreNasal FBFCSeizure algorithmMajor burnsCerebral SOLNeonatal abdoPaed Appx scoreKeratitisTrauma in pregnancyAAA ruptureCat biteNasal FB PAedTrauma in pregnancyFrequent presenter CyanideCCBTCAFWS Trauma in pregnancy imagingPhysiological differences in pregnancyMissed MILimitation to Rx/ NFRIndications for T'fer to Burns unitConveying bad newsMissed MIPt flowInstituting changeFull Trial 4Based onMMC 2015-2Preparation for major traumaNeonatal resusRSI unstable ptETT ConfirmationCapnography = zeroAnalgesia for PTXBiers blockMassive transfusionCardioversionEGDT-Variables- shock RxRhabdo RxPost STEMI MxElectrical alternans causesPericardial effusion - USCardiomyopathyMeningococcaemiaPalliative med RxSTEMI PostElectrical alternans( ??? change to De winters- ECG in SAQ folder)ARVDAXR VolvulusCXR PTXCXR traumaCTAbdoSpleen lacFBE UE CK- RhabdoABG HAGMA-? PE- A-a/ AG/ Corr. K+PetechiaKnee open woundNeck stickOrbital cellulitisFWT stripKawasakis (like w9 consider ?)BronchiolitisTesticular torsionKnee open woundTrauma- lethal triadChest trauma- Indic for urgent OTVolvulusNeck zonesPTX Rx optionsBiers blockSplenic trauma MxOrbital cellulitisTesticular torsionChest trauma- pulm contusions1st Trimester bleeding ? EPAntihistamine similar to Wk 20- consider changingΒ blockerHyperthermiaUS findings in electrical alternansUS ?Torsion testisUS ? EPComplaint re RxNFR issuesInappropriate Mx decision by I/P regAccess blockFlowKPIPt complaintSick leaveNFR orderFull Trial 5ACEM 2015-1VT- CardioversionNear drowningCerebral neuroprotectionToxic arrestVF algorithmPost VF MxMTPIntubation- AsthmaVentilator settings- pneumoniaWrist reductionAsthma- Ax & life thr RxVT- ECG featureCollapseSAH- severity/ prognosisTrifascicular blockPeriodic Paralysis- K+ECG in K+Fever returned traveller (W Africa)BCTBCT- toxicTrifascicular blockElbow Adult suprac #XR wrist Colles #Pelvic #AXR/CXR- sigmoid volvulusCTB SAHCTA- Cholecystitis Renal cystsFBE- A LeukaemiaVBG- K+ ABG- Met Ac- AG/ ?gap/ Ex CO2Knee jt aspirationPetechiaFebrile HepatosplenomegalyA LeukaemiaNAIOrbital/ preseptal cellulitisFebrile petechial rashSupracondylar #- adultAcute KneePelvic #Sigmoid volvulusCholecystitisMAP requestEclampsia/ pre EcMedical clearanceDelerium vs PsychosisToxic BCTAspirinNear drowningSnake biteInformed consentOpen disclosureStatutory rapeCode BrownNight club fireADR complaintADR preventionPaed death ................
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