Northern Nautical Nasties

This is the vodcast version of a talk I am giving at the Australian College of Dermatology meeting next week.

Why am I speaking at a Derm conference? Who knows! My knowledge of skin is superficial at best….

Anyway they wanted to know about things that might kill you in Broome…  so humans aside, these are the most dangerous things that I can think of at short notice.

I managed to get a local expert marine biologist / paleontologist / amatuer evolutionary biologist onto the podcast to share his 3 or 4 years experience in the field.

Thanks to the team at “Smarter Every Day” Youtube channel for allowing us to use some of their cool footage of vemonous things in super slow-motion.

Any questions about biology for Julius – comments below.  If you want to know about the tox stuff, ask Dr Chris Nickson.



OPEN IN A NEW WINDOW FULLSCREEN  (large video file – download at home!)


First10EM Journal Club: July 17

Welcome  back to the latest episode of the First10EM Journal Club with Dr Justin Morgenstern – the man who knows less about a lot than anyone I know!  You will have to listen to understand that backhanded compliment!

I dont KnowThis month we cover 9 papers on a range of everyday topics and as always a few eccentric pieces of information that you probably don’t need and certainly didn’t ask for!

DISCLAIMER: there are a few issues with the audio in a few short patches, and I have cut out the ugliest parts, but please persist and hopefully a few fruitful pearls will pass through the fog.

You can check out Justin’s written thoughts over at the FIRST10EM blog.  As always the full-text PDFs of the papers are attached below in hyperlinks for your reading convenience.

Here’s the audio,

or DIRECT DOWNLOAD in your browser.  We are on iTunes and any podcast feed app you can find.  If you get a minute please rate this podcast at iTunes.

Hinson JS, Ehmann MR, Fine DM. Risk of Acute Kidney Injury After Intravenous Contrast Media Administration. Annals of emergency medicine. 2017; 69(5):577-586.e4.

van der Hulle T, Cheung WY, Kooij S. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet (London, England). 2017;

Waldman N, Winrow B, Densie I. An Observational Study to Determine Whether Routinely Sending Patients Home With a 24-Hour Supply of Topical Tetracaine From the Emergency Department for Simple Corneal Abrasion Pain Is Potentially Safe. Annals of emergency medicine. 2017.

Vine SJ, Uiga L, Lavric A, Moore LJ, Tsaneva-Atanasova K, Wilson MR. Individual reactions to stress predict performance during a critical aviation incident. Anxiety, stress, and coping. 28(4):467-77. 2015.

Sinert R, Levy P, Bernstein JA. Randomized Trial of Icatibant for Angiotensin-Converting Enzyme Inhibitor-Induced Upper Airway Angioedema. The journal of allergy and clinical immunology. In practice. 2017.

Thelle A et al. Randomised comparison of needle aspiration and chest tube drainage in spontaneous pneumothorax. The European respiratory journal. 2017; 49(4).

Tschopp JM, Bintcliffe O, Astoul P. ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax. The European respiratory journal. 2015; 46(2):321-35.

Moran GJ, Krishnadasan A, Mower WR. Effect of Cephalexin Plus Trimethoprim-Sulfamethoxazole vs Cephalexin Alone on Clinical Cure of Uncomplicated Cellulitis: A Randomized Clinical Trial. JAMA. 2017; 317(20):2088-2096.

Reichert S, Lin C, Ong W, Him CC, Hameed S. Million dollar ride: Crime committed during involuntary scopolamine intoxication. Canadian family physician. 2017; 63(5):369-370.

Don’t forget to try and sign up for the awesome Don’t Forget The Bubbles Conference in Brisbane this month.  I will be there teaching Paeds US, talking about life as a rural Paeds / family doctor and having a great time.

There is also a mention of the Pomegranate Health Podcast produced by the Australian College of Physicians – they have released a few recent episodes on Diagnostic Uncertainty which are well worth a listen.


First10EM Journal Club: June DasSMACC Edition

Welcome back to the roughly monthly Journal Club with Dr Justin Morgenstern of First10EM fame.

This month we have a special edition for you – we invited 6 of our favourite EBM FOAMed folks to join us live in Berlin at DasSMACC.  We recorded the following podcast in the hotel lobby bar over a few pints of Germany’s finest ale.  This was a really fun session – we asked each participant to bring along a paper for discussion and we all chipped in to the chatter.  The voices you will hear are:-

  • Dr Andy Neill  – the fast-talking Irishman, who kindly recorded the whole deal.  You can hear more form him at the RCEM podcast.
  • Dr Justin Morgenstern – as always
  • Dr Andy Tagg, (from Don’t Forget the Bubbles) the Aussie-based Englishman with the most original English accent.
  • Dr Michelle Johnson (Aussie accent) of LITFL fame, bringing her usually written excellence to the spoken word.
  • Dr Pik Mukherji – the super sensible (even cynical?) NewYorker
  • Dr Connie Smith – one of my Aussie / Broome Residents with a penchant for all things ophthalmology
  • Dr Ben Smith (US of the Week) – the Tennessee-based POCUS guru and super nice guy.
  • And me, of course

OK, that is the cast of characters.  Now onto the podcast.  WARNING- it is a long one.  I would suggest breaking it into a few sections if you prefer.

As always the written summary is available over at First10EM and the whole PDFs for free on the hyperlinks below.  So listen, read, learn and share  – this is the essence of FOAMed and the reason we all came along to Berlin to share in the celebration that is SMACC.


Suggested by Michelle Johnston (@Eleytherius): Chan BS et al. Efficacy and effectiveness of anti-digoxin antibodies in chronic digoxin poisonings from the DORA study (ATOM-1). Clinical toxicology (Philadelphia, Pa.). 2016; 54(6):488-94.

Suggested by Ben Smith (@UltrasoundJelly): Gaspari R, Weekes A, Adhikari S. Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest. Resuscitation. 2016; 109:33-39.

Suggested by Andy Neill (@AndyNeill): Aagaard R et al. Detection of Pulmonary Embolism During Cardiac Arrest-Ultrasonographic Findings Should Be Interpreted With Caution. Critical care medicine. 2017; 45(7):e695-e702.

Suggested by Andy Tagg (@andrewjtagg): Humphreys S et al. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) in children: a randomized controlled trial. British journal of anaesthesia. 2017; 118(2):232-238.

Suggested by Dr. Pik Mukherji (@ercowboy) Egerton-Warburton D et al. Antiemetic use for nausea and vomiting in adult emergency department patients: randomized controlled trial comparing ondansetron, metoclopramide, and placebo. Annals of emergency medicine. 2014; 64(5):526-532.e1.

Suggested by Dr. Connie Smith (@halfbakeddoc) Rose PW, Harnden A, Brueggemann AB. Chloramphenicol treatment for acute infective conjunctivitis in children in primary care: a randomised double-blind placebo-controlled trial. Lancet (London, England). 2005; 366(9479):37-43

Suggested by Casey Parker (@broomedocs ): Spinner RJ, Poliakoff MB, Tiel RL. The origin of “Saturday night palsy”? Neurosurgery. 2002; 51(3):737-41.

Suggested by our EBM guru Dr Morgenstern ( @FIRST10EM )….   a “pucker of papers” on digital rectal massage – yes, really….

  • Roberge R et al. Termination of paroxysmal supraventricular tachycardia by digital rectal massage. Annals of emergency medicine. 1987; 16(11):1291-3.
  • Lieberman ME. Ventricular tachycardia as a complication of digital rectal massage. Annals of emergency medicine. 1988; 17(8):872. PMID:3395001 
  • Fesmire FM. Termination of intractable hiccups with digital rectal massage. Annals of emergency medicine. 1988; 17(8):872. PMID:3395000
  • Odeh M, Bassan H, Oliven A. Termination of intractable hiccups with digital rectal massage.  Journal of internal medicine. 1990; 227(2):145-6. PMID: 2299306