Consultant post advertised. For details see link:
http://www.publicjobs.ie/publicjobs/campaignAdvert/23140.htm
Emergency Department Staff SUPping on Lough Gill June 2015
Unfortunately, Dr Mick Killeen is returning to New Zealand after a year at the ED in Sligo.
We had a great year with him on our team, and he’ll be sorely missed
In order to bid him farewell , the ED crew (that weren’t on duty) spent the afternoon on Lough Gill learning to Stand Up Paddle (SUP) with SUPForAll. In treacherous conditions, the ED staff braved the elements. 
Celebratory meal, and awards ceremony that evening.
For more photos see www.facebook.com/SUPforall
Middle Grade Post available in Emergency Medicine in July 2015 (+other posts available in various specialities!)
Middle Grade Post Available July 2015
There is an opportunity in July 2015 for a Middle Grade in Emergency Medicine. Our trainees have a good past record of getting places on Advanced Specialist Training Schemes in Emergency Medicine in Ireland, UK, and Australasia. The rota is European Working Time compliant with very few night shifts, and one-in-four weekends.
Candidates are expected to have a keen interest in gaining experience in Emergency Medicine at a Middle Grade level, with previous EM experience essential.
For further details on the post and how to apply contact ed.admin@hse.ie, or ramona.coen@hse.ie
Other Registrar Posts Available in other specialties at Sligo Regional Hospital for July 2015
There are also opportunities at Registrar Level at Sligo Regional Hospital in the following specialties:
- Internal Medicine
- Anaesthetics
- Obstetrics & Gynaecology
For further details on these posts and how to apply contact ramona.coen@hse.ie
Middle Grade Post Available July 2015
Middle Grade Post Available July 2015
There is an opportunity in July 2015 for a Middle Grade in Emergency Medicine. Our trainees have a good past record of getting places on the National Advanced Specialist Training Scheme in Emergency Medicine. The rota is European Working Time compliant with very few night shifts, and one-in-four weekends.
Candidates are expected to have a keen interest in gaining experience in Emergency Medicine at a Middle Grade level, with previous EM experience essential.
For further details on the post and how to apply contact ed.admin@hse.ie, or ramona.coen@hse.ie
Joint ED/Paeds Training session Apr2015
Busy morning today with our paediatric colleagues.
Simulated sick infant scenario in resus.
Well done to all who organized and took part.
PS Baby’s doing well
NUIG Med Students Attend Special Study Module
Medical Students attended an afternoon in training on sports-related pre-hospital emergencies.
Extraction techniques, spinal immobilisation and transfer, and airway management were covered.
Teaching APRIL 2015 onwards
SCHEDULE
16 APRIL PROCEDURAL SEDATION / AIRWAY ( Mick , Sol, Saffras )
23TH APRIL PAEDIATRIC CASES QUINS SISTERS ET ALL
30 APRIL M and M – middlegrade doctors ( and anyother doctors they enlist )
7 MAY Respiratory emergencies . NIV / management of type two respiratory failure / CAP / chest drain / severe asthma / anaphylaxis / VBG v ABG .
14th MAY -SHO presentations pick one : procedures plastering / ABG interpretation / ultrasound guided procedures / ECG interpretation / csf interpretation / xray interpretation / CT interpretation / novel joint reduction . Presentation must be contemporary and from emergency medicine literature or FOAMEM
21 May OSCE ( based on all teaching ) All registrars to be tested on procedural sedation and ultrasound
28TH MAY : M and M ( middlegrade doctors )
5th June Journal club : all nchds best articles in critical care /EM in last 12 months ( or favourite other journal for non ED trainees)
12 june : Ultrasound day
19th june :
LOWER LIMB INJURY
THE FOLLOWING IS A SUMMARY OF THIS THURSDAYS TALK ON LOWER LIMB INIJURY
It is surprisingly short considering Orthopoedics is a bottomless pitt of detail . This brief runthrough injury to the lower limb highlights the big issues from ourside of story . It is not important to know the difference between the treatment of an intracapsular Neck of Femur fracture and an intertrochanteric fracture .It is however crucial to understand that delay to operation of either ( past 48 hours ) impacts heavily on mortality and how to avoid this by making sure all the anaesthetic “tick box’s” are ticked. It is also important to make sure the patient is not in pain (hence the emphasis on regional anaesthesia
PELVIC FRACTURE IS THE FIRST
here is a link to a great EMRAP TALK ( 2014) on contemporary approach to exanginating pelvic trauma
https://d140vvwqovffrf.cloudfront.net/media/segment/original/972c3fcf990eca3d477367e6d9b572897e0e1aa9.mp3
(if the link above doesnt work just select it and past into your browser )
scot wingart ( http://emcrit.org/podcasts/severe-pelvic-trauma/ ) gives a good up to date summary on the emergency managment of pelvic injury and covers most of the topics in the talk
In the patient who is stable enought to go to CT , usually the CT angiogram will reveal the need for either embolisation via the angiosuite or OR for solid organ injury or ruptured hollow viscous .
low pressure venous bleeding often stabilises by good intensive care but may need packing
In the patient who is unstable ( ie BP <<100) these patients are devided into those who likely have intraabdominal injury as a cause ( ie FAST POSITIVE ) and those that dont
the next important orthopoedic injury is the hip fracture ( obviously less likely high speed trauma and more likely old person
CRITICAL POINTS FOR ED
These guys need their operation in 48 hours less ( or else they do worse ) and they also need pain relief
to faciliate their speed to OR we need to make sure all the pre op boxes are checked and hence the need for a NOF pathway
the following slide shows you what is important to anaesthetic doctors taking a patient to theatre
so make sure these tests are done
the next most important thing is to perform a femoral nerve block
if you havent a lot of exeperience use lignocaine 1% and use about 20-30 mls ( avoid LATS)
and look at this link for an indepth demonstration on how to do a fascia iliaca block
http://3lliottjody.wistia.com/medias/0g25pucqw5 ( copy and paste this into your browser )
moving down the leg : femoral shaft fractures can loose buckets of blood so you should predict and correct this . A Thomas splint ( or equivalent ) is necessary for pain relief and to stop bleeding. Make sure you give a femoral nerve block
knee fractures are the domain of the orthopoeidic service . Our job is not to miss any injury that might need earlier follow up or suggest sigficicant ligamentous or even vascular injury
the following xrays are ones that we should all be able to diagnose and get prompt orthopeodic consultation on
1) knee dislocation should be suspected on history and any significant intraarticular fracture . Have a low threshold for getting an angiogram ( to avoid amputation and litigation ) . ANKLE /BRACHIAL ABIs > 90 % have a good negative predictive value and maybe a useful adjunct
2) the segond fracture suggests a medial injury : collateral ligament / AC and meniscal injury (the unhappy triad )
3) the reverse segond suggests similar pathology on the medial side
4) tibial plateau fractures can be subtle
5) the FBI sign is give away for significant fracture ( fat blood interface )
6) dont foreget the massoneuvre fracture
7) ankle fractures are common in ED . Its important to know that a weber B or C are the ones that need surgery
8) bimaleolar and trimaleolar fractures need reduction in ED
9) consider a sciatic / POP fossa block if you cant adminster procedural sedation follow this link for the how to video , remember that it takes half an hour to work
( copy and paste this link http://3lliottjody.wistia.com/medias/vkw4qsewbx )
1) the ankle is best put back in dorsiflexion / traction and pressure backward along the direction of dislocation
11) this is a lisfranc fracture and often needs surgery ( subtle lisfrancs can be missed ) the whole point of the the oblique food xrays to is expsoe the alignement of the lisfranc articulation
12) Jones fracture bad . Psuedo Jones good . growth plate lines run parallel to axis of bone and would be embarrasing to mistake as a fracture
CSTEM PreHospital Trauma Scenarios
Pre-Hospital Trauma Training Day for CSTEMS on 11th April in Ballina, Co. Mayo. Supervised by Consultants and SpRs in EM.
Any CSTEM trainees interested see attached flier
New Vacancy: The Sligo Regional Hospital EM / Orthopaedics Rotation
The Sligo Regional Hospital EM / Orthopaedics Rotation
NOTE:
THIS POST HAS BEEN FILLED FOR THE JULY 2015 INTAKE. If you are interested in applying for this post for January 2016 contact ed.admin@hse.ie
We have an exciting new vacancy available for SHOs from July 2015.
The successful candidate will spend 3 months as an SHO in Emergency Medicine and 3 months as an SHO in Trauma/ Orthopaedics.
If in the initial 6 months the performance is satisfactory, there may be opportunities for the candidate to complete a further 3 months in EM, and 3 months Acute Medicine.
This six/ twelve month rotation will offer the candidate a good introduction to Emergency Medicine in Ireland, and should put him/her in good position to apply for a formalized training program.
Candidates must be eligible for registration with the Medical Council of Ireland (http://www.medicalcouncil.ie/)
For further information on how to apply, please contact ed.admin@hse.ie
