Week two case presentation / ultrasound and emergency medicine and the internet

Teaching 31 st August 2014 SGH DEM 
1) post lumbar puncture headache – Muhammad case presentation and discussion 
2) introduction to ultrasound use in the emergency department – mick killeen 
3) FOAM , emergency medicine resources online 
Please pick a website that you use ( or will use from now on ) and present a five minute talk based around some clinical question and how and why you use this particular source. Below are 2 examples 
Clinical question 
Background : everywhere I work people seem to have strong opinions about thrombolysis in stroke and the world seems to be devided  on their interpretation of the literature – where can I get a good pro and con review on this subject ? 
Clinical question 
What are the controversies around thrombolysis in acute ischemic stroke 
Chosen  website ( 3 chosen) 
Emcrit  – why ? Because I have followed his blogs for years and have grown to trust his blogs and podcast. They are well referenced , make scientific sense and are cutting edge http://emcrit.org/podcasts/tpa-for-ischemic-stroke-debate/
David Newman – a well known cynic and very knowledgeable ed physician who published on a well known website known as the NNT
Plus EMA ONLINE ( emergency medical journal of Australia ) – why ? because I get it free through college of em and I remember seeing this article which was a ballanced counter argument in favour of thrombolysis. 
Example 2 .
Clinical question : does tamsulosin help patients in ed with renal colic? 
Chosen website : http://thesgem.com/2014/04/sgem71-like-a-rolling-kidney-stone-a-systematic-review-of-renal-colic/
Why : well actually looking for bestbets and cochrane articles but found this one first and it made a lot of sense I then also looked at this site and saw a debate raging in the replys. It answered my question for me ( for now) 
If you are not sure of a topic check with a senior. 
Thanks in anticipation 

 (   The cycle to work last week) 

week one – cardiovascular

talk one  – the futility of the exercise tolerance test . The goal is to squeeze all this information into two ten minute talks
see the following links for all the information you need (you may want to glance at some of the references )

talk two – universal definition of MI / ECG criteria for STEMI including scarbossa dewinter posterior and right ventricular infarct and the significance of STE in AVR (ten minutes ).see the following links

talk three – MI Mimics ( on ECG) BER / ANEURISM / SAH / Dissection prox aorta / Pericarditis .

talk 4 – unstable angina – time for a requiem ?

talk 5 – regional wall abnormality on bedside echo -mick – if time


   TEACHING for Second half of the year (2014)
Purpose of teaching
-Cover some of the core medical and surgical and Paediatric topics of Emergency Medicine
-To maintain quality and uniformity or practice for all doctors in ED with a focus on day to day clinical practice as well as more rare but life-threatening emergencies
TOPICS ( not necessarily in this order )
1) Management of Acute cardiac emergencies including ACLS review
2) Management of acute respiratory emergencies including Airway management and  RSI )
3) Management of acute Neurological Emergencies including CVA (SAH/thrombolysis debate / stroke and TIA guidelines / syncope )
4) Vascular Catastrophes . AAA/ dissection  / cardiac Tamponade
5) Trauma management – Recent updates eg ICEM , Damage control resuscitation / crash 2 trial / TTM trial
6) Orthopaedic injuries ( pelvis / longbone / hand and foot / soft tissue injuries to shoulder , knee , wrist and ankle
7) The focussed clinical exam in 2014 – Different Joints / formal Cardiac exam / neurological examination .
9) Paediatric Emergencies ( Assessment of the unwell child / PALS / APLS / APLS review / NAI
10)Interpretation and management of Acute Electrolyte disturbances (hyperkaleamia / acid base / hyponatremia / Hypernatremia / DKA / Honk / Acute renal failure )
11) The critically ill patient – Sepsis bundles / BOIC / Post cardiac arrest management / post intubation check list / inotropes / antibiotics in serious sepsis
12) Toxicology – general approach / Specific and common life-threatening overdoses. Seratonin and anticoholinergic syndrome

SUB Structure

“Reversed class room” philosophy – Trainees present short talks for every teaching program ( no talk longer than 15 minutes , usually 5-10 minutes )
“Expert panel” discussion (consultant/SPR/guest )  will discuss afterwards
ideally real life cases will be discussed
A teaching session should have a summary / consensus at the end , so that the information obtained can be used for real life clinical work in ED ( or to pass exams!)
Talks will be posted on the blog each week ( with all patient sensitive information de-identified )

follow this link  (tap the images)  for trustworthy and free internet resources for up to date resources . A good start for any talk you might have to do .


iPERM – Best oral presentation goes to Sligo ED

Congratulations to our Specialist Registrar, Dr Michael Bennett who won the prize for best oral presentation at the Irish Paediatric Emergency Research Meeting on Friday 4th July 2014.

Michael presented on the experience in Sligo ED of using ketamine as part of a safe sedation pathway in children undergoing painful procedures.  He has demonstrated that our practice is both safe an effective.  You can read about his work and how we do things here.


Photo: Michael Bennett receiving his prize, with Dr Turlough Bolger (Tallaght), Dr Roisín McNamara (Temple St), Dr Sam Deiratany (Temple St).





Unfortunately Michael’s time with us in Sligo has come to an end today.  We wish him well in his new post in Crumlin on Monday.  Indeed, we would like to thank all our non-consultant hospital doctors for their hard work and look forward to meeting our new trainees on Monday next.

ICEM 2012

ICEM Conference 2012

The Irish Association for Emergency Medicine has been chosen to host the 14th International Conference on Emergency Medicine on behalf of the International Federation for Emergency Medicine (IFEM).


The conference will take place from 27th to 30th June 2012 in the newly opened Dublin Convention Centre in Dublin’s Docklands.

Launch of New Website

Sligo Emergency Department Website Launch
Sligo Emergency Department Website Launch

The Sligo Emergency Department website officially launched on 23.06.2010.

We hope you like the results so far. The site aims to provide the general public with all the relevant information pertaining to the Emergency Department, as well as information and links to general health issues.

The site will continue to change and grow over the coming months. We will continue to update the content, in an attempt to communicate with and inform the public as best we can.

We hope you’ll come back and visit us again soon!!