OzEMedicine - Wiki for Australian Emergency Medicine Doctors

the painful shoulder - [clinical assessment clues]

gary1@undisclosed.example.com (gary1) — Fri, 26 Jun 2026 12:34:01 +0000

the painful shoulder see also: * orthopaedics in the ED * the acutely painful elbow * interscapular thoracic back pain introduction * shoulder pain is a very common presentation to the ED * closely check to ensure it has not been dislocated clinical assessment clues * no increase of pain on full movement of the shoulder suggests

hypoxia - [Alveolar ventilation to predict PaCO2]

gary1@undisclosed.example.com (gary1) — Fri, 26 Jun 2026 03:31:53 +0000

hypoxia see also: * oxygen * arterial and venous blood gases (ABGs/VBGs) * home oxygen * respiratory medicine oxygen content in blood introduction * hypoxic hypoxia can be arbitrarily defined as arterial oxygen partial pressure of less than 80mmHg in room air * an arterial PO2 < 60mmHg indicates respiratory failure as, at oxygen levels below this, the Hb-oxygen dissociation curve is steep which means that the ability for Hb to carry much oxygen to the tissues is markedly diminished, …

innate immunity - [the inflammatory response]

gary1@undisclosed.example.com (gary1) — Thu, 25 Jun 2026 08:53:56 +0000

innate immunity see also: * immunology * adaptive immunity * cytokines introduction * innate immunity is a term used to refer to all types of immunity excluding adaptive immunity (acquired / adaptive immunity relies upon immune cells such as T-cell and B-cell lymphocytes which produce antibodies and these immune systems arose late in evolution, appearing in vertebrates), and thus is relatively non-specific

psilocybin (magic mushrooms) - [Pharmacology]

gary1@undisclosed.example.com (gary1) — Thu, 25 Jun 2026 07:36:59 +0000

psilocybin (magic mushrooms) see also: * toxicology * mushroom poisoning * novel psychoactive substances (NPS) Introduction * psilocybin “magic mushrooms” are often used as psychedelic hallucinogens with relatively short duration of effects although these can cause severe serious psychological adverse effects, and rarely respiratory paralysis

Wood-lover paralysis - [Pathophysiology]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 08:27:17 +0000

Wood-lover paralysis see also: * psilocybin (magic mushrooms) Introduction * a rare toxidrome, mainly associated with the consumption of the psilocybin native Australian cold climate hallucinogenic wood decomposing mushroom Psilocybe subaeruginosa (aka subs or gold tops) which tends to grow on wood chips and which also can be found in NZ (and it seems some have made their way to northern hemisphere via wood chipping industry) but it seems the toxidrome only occurs uncommonly even with ing…

the brain - [Default mode network (DMN)]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 08:17:21 +0000

the brain see also: * brain evolution and development * cerebrospinal fluid (CSF) * stroke (CVA) * neurology * consciousness * memory * speech * dementia * modelling the brain: * Dec 2023: Uni of Cambridge, UK, announces by using their new concept 3D “spatially embedded recurrent neural networks” (seRNNs) they have created a self-organizing, artificially intelligent system that uses the same tricks as the human brain to solve specific tasks. The seRNNs converged on structural and f…

the shocked patient

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:49:04 +0000

the shocked patient * for ADULTS * a persistent systolic BP below 90mmHg or drops more than 40mmHg below their baseline, or a mean arterial pressure (MAP) below 65mmHg is highly suggestive of shock * a person can be in shock with a normal BP if that BP is unable to maintain tissue perfusion

hypotension - [Introduction]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:45:46 +0000

hypotension see also: * the shocked patient * postural hypotension (orthostatic hypotension) Introduction * low blood pressure may be: * transient unrelated to posture * eg. SAH, initial PE embolism, vasovagal, in response to Valsalva (eg. micturition syncope), post-prandial, transient arrhythmia *

anti-muscarinic anticholinergic agents - [Tertiary amine antimuscarinics:]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:20:35 +0000

anti-muscarinic anticholinergic agents see also: * pharmacology main index * parasympathetics - the actions of muscarinic receptors Summary of anticholinergic effects: * mydriasis, cycloplegia, tachycardia, antispasmodic GIT; * dry mouth, decr. fasting gastric acid secretion; decr. motility; * dilates pelves, calyces, ureters, bladder;

autonomic dysfunction and autonomic neuropathy - [Autonomic dysfunction and autonomic neuropathy]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:19:46 +0000

autonomic dysfunction and autonomic neuropathy see also neurology; sympathomimetics; parasympathetics; anatomy of the autonomic nervous system Autonomic dysequilibrium: * The development of profound autonomic dysfunction and of neuroendocrine activation characterizes and possibly contributes to the progression of heart disease to congestive heart failure. Sympathetic activation is a generalized process and the proposed mechanisms for neurohumoral activation include decreased input from excit…

syncope / near syncope - [Syncope and falls in the elderly]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:19:30 +0000

syncope / near syncope see also: * seizures * the blood donor who collapses * vertigo - peripheral vs central * postural hypotension (orthostatic hypotension) * the dizzy patient (dizziness) Introduction * syncope and near syncope are one of the most common presentations to the ED and need to be differentiated from a primary seizure event (seizure activity may be secondary to the syncopal event if there is prolonged reduced blood supply to the brain)

postural hypotension (orthostatic hypotension) - [postural hypotension (orthostatic hypotension)]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:07:00 +0000

postural hypotension (orthostatic hypotension) see also: * the dizzy patient (dizziness) * the shocked patient * hypotension * postural orthostatic tachycardia syndrome (POTS) * anorexia nervosa / eating disorders Introduction * postural hypotension is a significant fall in systolic BP upon standing * it may also have postural tachycardia Measurement * lie patient down for 5 minutes

the dizzy patient (dizziness) - [Introduction]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:06:29 +0000

the dizzy patient (dizziness) see also: * postural hypotension (orthostatic hypotension) * ED Mx of vertigo and BPV Introduction * the symptom of dizziness is a very common cause of presentation to the ED in adults * the clinician must make every effort to distinguish between the two main groups of causes of dizziness:

ED Mx of vertigo and BPV - [ED Mx of vertigo and BPV]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 06:02:19 +0000

ED Mx of vertigo and BPV see also: * the dizzy patient (dizziness) * neurology * ears, nose and throat surgery (ENT) * anti-emetics * central vs peripheral vertigo * see HINTS exam for vertigo and stroke * Cutting-edge technology helps Eye and Ear patients - Melbourne Neuro-ENT with special interest in vertigo introduction * all vertigo is made worse by moving the head * if vertigo lasts < 1 minute after moving the head, this suggests BPV * most other causes result in vertigo l…

the patient with acute blurred vision or visual loss / blindness - [amaurosis fugax]

gary1@undisclosed.example.com (gary1) — Wed, 24 Jun 2026 05:48:08 +0000

the patient with acute blurred vision or visual loss / blindness see also: * ophthalmology * Eye injuries * diplopia / double vision * color blindness / color vision deficiency introduction * acute non-traumatic blurred vision is a relatively common presentation to ED * patients may use the term blurred vision to cover a number of different symptoms such as:

postural orthostatic tachycardia syndrome (POTS)

gary1@undisclosed.example.com (gary1) — Tue, 23 Jun 2026 01:25:47 +0000

postural orthostatic tachycardia syndrome (POTS) see also: * dysautonomia syndromes * anorexia nervosa / eating disorders

ophthalmology - [ophthalmology]

gary1@undisclosed.example.com (gary1) — Tue, 23 Jun 2026 01:21:02 +0000

ophthalmology * eye injuries * welder flash burns - UV keratopathy (photo keratitis) * retrobulbar haemorrhage * chemical injuries and burns to the eyes * corneal abrasions * keratitis * the patient with acute blurred vision or visual loss / blindness * diplopia / double vision * conjunctivitis * acute atraumatic painful red eye(s) * glaucoma * uveitis * episcleritis * fundoscopy * optic neuritis * macular degeneration * cataracts * local anaesthetic agents * mydriatics …

headache - [CT brain (non-contrast) while in ED:]

gary1@undisclosed.example.com (gary1) — Tue, 23 Jun 2026 01:19:34 +0000

headache see also: * meningitis * the child with headache * subarachnoid haemorrhage (SAH) * migraine * acute unilateral headache * cervicogenic headache * a diagnostic approach to the adult with acute headache * AFTB lectures - headache introduction: * patients with headache as a prime feature are a worrying group of patients as there are a number of potentially life threatening or morbid conditions that, although uncommon, are easily missed:

mydriatics - [Contra-indications]

gary1@undisclosed.example.com (gary1) — Tue, 23 Jun 2026 01:12:56 +0000

mydriatics see also: * ophthalmology * acute atraumatic painful red eye(s) Introduction * mydriatics are agents used to dilate the pupil of the eye, primarily to allow fundoscopy, but can also be used to treat uveitis Contra-indications * known or suspected narrow-angle glaucoma * iris-clip intraocular lenses as mydriasis may cause the lens to dislocate

Yersinia including bubonic plague and Yersiniosis - [Yersinia pestis]

gary1@undisclosed.example.com (gary1) — Mon, 22 Jun 2026 23:58:15 +0000

Yersinia including bubonic plague and Yersiniosis see also: * clinically important bacteria * A historians' view of the bubonic plague introduction * Yersinia are Gram-negative, rod-shaped coccobacillus, a facultative anaerobic bacteria belonging to the enterobacteriaceae family * Y. pestis is the organism causing the bubonic plague or Black Death epidemic and thousands of cases each year still occur