Sunday, 27 April 2014

Tuesday teaching -- all things sodium

Hullo All,

Great teaching session yesterday.

Thank you Niluka for a wonderful session on Paediatric Wheeze and an approach to Bronchilitis and Asthma. Some interesting points were made regarding use of Ventolin in the under 1’s. This has not been my practice formerly – does anyone know of any evidence around this? If not I’ll look prior to the next session.
Lynda wowed us all with her hyponatraemia talk – a very interesting case of a child who was embarrassed about bedwetting and overdosed on his desmopressin and a comatose fire fighter who ended up having water intoxication.  Again some controversy that I feel we are
yet to clear up re  Acute Hyponatraemia treatment.  My personal preference in the past was to reserve 3% Nsaline for patients with a Na below 120 and severe symptoms, such as seizures or comatose. Confusion I had not included in my indications for hypertonic, particularly if there was a readily reversible cause (ie very dry where Nsaline will do the trick anyhow). There was some debate about this and Tharindu has sent these articles, so let’s read before next week and then readdress this.

Hayden Grossed us all out with a case of crusted scabies in a immunosuppressed man – where his scabies covered him in a waxy flaky off yellow coloured armour where the skin scraping filled the yellow pot and required IV therapy  for treatment. OOH! This led us to the approach to rashes and infection control measured in ED.

Tharindu revealed himself as the king of ECG’s getting 12 ECGs in a row correct, followed by naming 6 causes of Prominent R in V1 – you are great Tharindu, I had thought there were only 5!

Heaps of Good stuff coming  up

Next week we start with exam teaching, then over to Deakin Medical school at 1030 for the supersession in the lecture theatre for some crit care cases and a presentation on Resp support for Children by Claire Cattigan and myself.

Giles Craig is going to be taking monthly sessions, which I had originally called  "lets not be hyperdense" but have settled for "no clinical correlation required",

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