Emergency Medicine Blog

Legal Definition of a Child in Malaysia and the Definition of Statutory Rape

2012-05-11T22:41:00.000+08:00

Image downloaded from Microsoft Office website. Available at here. I made a mistake when discussing on the legal definition of a child in Malaysia and the definition of statutory, and so I thought it would be a good idea to revise on this topic. I mistakenly thought that a child in Malaysia is defined as one aged 18 years old and below. I was wrong. According to the Malaysian Child Act

Advanced ECG by Amal Mattu in Singapore

2012-02-24T01:22:00.001+08:00

Attended the Advanced ECG workshop tomorrow conducted by Prof Amal Mattu in the Society for Emergency Medicine in Singapore 2012 Annual Scientific Conference (SEMS ASC). A number of good streaming video ECG lectures by him in this website. Click here to assess. Some highlights from the class: Sgarbossa's criteria The dictum that "in the presence of LBBB, one cannot diagnose myocardial

Grey-Turner Sign

2012-02-20T09:07:00.000+08:00

Grey-Turner’s sign simply refers to the bluish discoloration of the flanks. The interesting thing about this sign is that whenever this sign is found, medical students are alerted to the fact that there is a possible underlying retroperitoneal bleeding going on. Obviously, this sign could also indicate a possible intraperitoneal bleed besides the possibility of retroperitoneal bleed. The

Elderly Abuse in Malaysia

2012-02-14T23:56:00.001+08:00

The official visit by the undergraduate students and their lecturers from Tzu Chi University from Taiwan ended a week ago. During that visit, I talked about elderly care and abuse, particularly within the Malaysian context because I feel this is one area which is not very much talked about, not easily detected, and in fact, what we know is probably the tip of the iceberg only. This forum

Heuristics and Cognitive Biases in Decision Making During Clinical Emergencies

2012-01-18T00:43:00.000+08:00

When faced with a potential clinical emergency situation, physicians are often expected to make diagnostic decisions within a limited time frame. A delayed decision, albeit an accurate one, is a futile decision if the patient deteriorates. Therefore, as almost always, such urgent decisions have to be made with some degree of uncertainty. This is especially so in an environment like the emergency

Severe Sepsis Talk by Emmanuel Rivers (Originally posted in EMCrit Blog)

2011-09-04T14:06:00.007+08:00

Early goal directed therapy (EGDT) is a series of targeted treatment measures directed aggressively and as early as possible for the first 6 hours for patients with severe sepsis and septic shock. The EGDT was first conceptualized by Emmanuel Rivers. The EGDT was well known through a landmark paper published in NEJM (looking back, this paper is already 10 years old!): Rivers E., Nguyen B.,

Prehospital Care in Malaysia and Kendrick Extrication Device

2011-08-14T22:05:00.012+08:00

Prehospital care in Malaysia - Issues and Challenges View more presentations from Chew Keng Sheng This talk was the first lecturer that I gave during the Prehospital Care course that I conducted for the Red Crescent volunteers of Penang Branch Malaysia. This slide was prepared based on a commentary journal article that I wrote together with Dr. Hiang Chuan Chan from Kuching Sarawak. Red

Some Lessons Learned From ACEM 2011 Bangkok - Emerging Drugs of Abuse in Asia and Riot Control Agents

2011-07-14T00:39:00.022+08:00

In every conference that I attended, I tried to learn at least one or two things, if not, more. In ACEM 2011, I find that the toxicology track was particularly interesting. Two specific topics are of particular interest to me (since they are relatively new stuffs to me):Emerging Drugs of Abuse in AsiaRiot Control Agents In this blog post, I will share some of the things I learned from

Hypopyon

2011-06-25T12:02:00.003+08:00

A hypopyon is a pus collection within the anterior chamber of the eye.Patients will present with pain, irritation, itchiness of affected eye. Some may have decreased visual acuity or photophobia. This patient did not have decreased visual acuity or photophobia other than the limited visual field besides the pain and irritation.It is not a disease per se, but a presentation of diseases. It can

The Rule of Six in Infusion Part 2 - The Pros and Cons

2011-06-24T19:16:00.006+08:00

For the last one week, there has been some interesting discussion in my group on the use of the rule of six for infusion. I have previously written a blog post on this.According to an article (click here to access), the rule of six is not optimal for patient safety - which I sincerely agree. Some of the points raised in that article:1. the rule of 6 is not followed consistently. Some

3rd Malaysian International MMA Medical Students Conference on Trauma

2011-06-05T12:54:00.005+08:00

The 3rd Malaysian International MMA Medical Students conference held at Melaka-Manipal college has just concluded (2nd - 5th June 2011). I must say that it was a huge success given the limited resources they have, especially since the committee members themselves are busy medical students, many of whom are clinical students. I wish that more medical students from Universiti Sains Malaysia could

First Aid: Principles and Practice (Updated According to AHA Guidelines 2010)

2011-04-11T19:30:00.002+08:00

This is the set of slide that I used during my recent lecture The Principles and Practice of First Aid for First Year Medical/Dental Students in early January 2011. First aid 2011 View more presentations from Chew Keng Sheng

Recommended Website: Life in The Fast Lane

2011-03-22T01:13:00.003+08:00

Life In The Fast Lane is, as it describe itself, is "a medical blog and website dedicated to providing online emergency medicine and critical care insights and education for everyone, everywhere... usually with a healthy dose of good humour, and always with endless enthusiasm".There are many great resources over there, but one particular feature that may especially interest candidates sitting for

Lecture Slides On Toxic Gases and An Introduction To CBRNE Weapons

2011-03-18T21:52:00.005+08:00

Toxic gasesView more presentations from Chew Keng Sheng.CBRNE - An IntroductionView more presentations from Chew Keng Sheng.Overview of CBRNEChemical agentsBlood agentsNerve agentsBlistering agents1. Blood agentsCyanide groups2. Nerve agentsG series and V seriesG series - made in Germany (that's why it is called G)GA Tabun, GB (Sarin - used in Aum Shinrikyo 1995 attack), GD (Soman)V series e.g.

Book Review: Enchantment: The Art of Changing Hearts, Minds, and Actions by Guy Kawasaki

2011-03-12T22:35:00.029+08:00

Product Information:Name: Enchantment: The Art of Changing Hearts, Minds, and ActionsPage count: 224Year of first printing: 2011ISBN: 9781591843795Although this book is not directly related to emergency medicine, but Enchantment: The Art of Changing Hearts, Minds, and Actions by management guru, Guy Kawasaki, has a lot to teach us, doctors in ER, on the one of the very important aspect of

Chain of Survival AHA Resuscitation Guidelines 2010

2011-02-06T12:00:00.004+08:00

Image link: http://circ.ahajournals.org/content/vol122/18_suppl_3/images/large/zhc1431087430001.jpeg (AHA Website)To increase the chance of successful resuscitation following cardiac arrest, this requires an integrated set of coordinated, sequential actions represented by a chain of links. This is known as the Chain of Survival.The links include the following:Immediate recognition of cardiac

Book Review: Connected for Health: Using Electronic Health Records to Transform Care Delivery

2011-01-24T06:14:00.016+08:00

Product Information:Hardcover: 272 pagesPublisher: Jossey-Bass; 1 edition (May 17, 2010)Language: EnglishISBN-10: 0470639377ISBN-13: 978-0470639375Product Dimensions: 9.2 x 7 x 0.9 inches Connected for Health: Using Electronic Health Records to Transform Care edited by Louise L. Liang is an account that chronicles the implementation of electronic health record (EHR) by Kaiser Permanente (KP).

First Aid Recommendations Updates

2011-01-23T14:17:00.022+08:00

The American Heart Association (AHA) together with the American Red Cross have published a series of updates in conjunction with the 2010 AHA and Emergency Cardiac Care (ECC) Guidelines on Basic Life Support and Advanced Life Support.Download the pdf file of this 2010 AHA first aid updates here.NB: Please note that all the recommendations by AHA and American Red Cross stated below are for first

Etomidate Versus.....

2011-01-04T16:29:00.004+08:00

Widely used as an induction agent, etomidate is an ideal agent for emergency endotracheal intubation because:of its predictability in dosingreliable hypnotic effectrapid onset short duration of actionit has no effect on histamine release, which contributes to its hemodynamic stability.Unfortunately, since the early 1980s, there has been concerns about the use of etomidate in critically ill

Blogs Recommendations

2011-01-04T09:58:00.003+08:00

EM.Crit Blog has listed 12 of his favorite emergency medicine/critical care blogs. You may want to follow them. Click here.In fact, EMCrit itself is an excellent blog worth following. The blog includes podcast in free mp3 downloads. You can subscribe their RSS. Click here.

Scientific Writing - Challenges Within The Malaysian Context

2011-01-03T15:45:00.002+08:00

Below is my presentation slide during the 1st National Symposium in Emergency and Acute Care held in Universiti Sains Malaysia. Feel free to download by clicking here.Scientific writingView more presentations from Chew Keng Sheng.

Bowel Obstruction

2010-11-15T09:30:00.002+08:00

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Resource Review: WikiRadiography

2010-11-14T10:34:00.003+08:00

WikiRadiography has many good articles, videos, tutorials, etc on radiographs and X-ray films.This site is primarily meant for radiographers and sonographers as shown in their philosophy statement:This site was designed to foster education, learning, development and advanced practice specifically for radiographers and sonographers. Alot of time and effort has been spent creating a site that is

2010 AHA Guidelines on ECC and CPR

2010-11-10T04:03:00.005+08:00

The American Heart Association (AHA) has recently updated the CPR and ECC Guidelines. You can access the full text pdf files of "AHA CPR and ECC Guidelines 2010" articles published in 18 October 2010 issue of Circulation by clicking here.The most obvious and sensational change would probably be the change from the A-B-C to the C-A-B sequence of basic life support. In a way, I am not at all

Emergency Physicians International (EP International) 2nd Edition

2010-10-09T10:34:00.006+08:00

Embedded below is the digital copy of EP International 2nd edition that is just released. Those who are participating in the European Society of Emergency Medicine (EuSEM) biennial meeting would receive the physical copy. The original source of the digital copy can be found here. You can download a pdf copy by login in to issuu homepage.I have personally written a page regarding the development