MD
3.8K posts


Update;
2010 Em Training start In Turkey
2016 Em Consultant in Turkey
2018 Toxicology PhD
2020 a new life in Scotland
August '21 MRCEM Primary ✅
March '22 MRCEM SBA ✅
December '22; MRCEM OSCE ✅️
And Today; FRCEM OSCE✅️
Bulut Demirel@MedicEducate
Update; 2010 Em Training start In Turkey 2016 Em Consultant in Turkey 2018 Toxicology PhD 2020 a new life in Scotland August '21 MRCEM Primary ✅ March '22 MRCEM SBA ✅ TODAY; MRCEM OSCE ✅ As a MRCEM;Now ready for FRCEM's!
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@SueIeraci yep, haven’t read study only article/TV feature, think acute back pain has a 6-12 week definition in guidelines generally ? 2 week post onset would limit ED extrapolation, also interesting that illustrative case @abcnews to illustrate the point is effectively a chronic case
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@ToxTalks The messages from the new Lancet study are highly misleading. They talk of "acute" pain but their first pain assessment was at 2 weeks. None of the authors are around when people present in acute severe pain and need relief. Long-term is different.
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@AmSidlak @mareeconnor it’s intended as a general prompt for senior involvement as pt needing 3 back to back sedations is a red flag for a difficult to sedate case, it’s not for the specific sedative being administered
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@ToxTalks @mareeconnor senior medical consultant needed prior to giving 5 mg of versed... excuse me
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My first ever poster in an International Conference. Happy to get a spotlight in the largest Emergency Conference of the world ICEM 2023, Amsterdam, the Netherlands.
Tim Coats@TJCoats
Poster at #ICEM2023 new for me - Salbutamol associated lactic acidosis. Asthmatic patient increasingly breathless, lots salbutamol given. High lactate , no wheeze, normal/high pH. Easy mistake clinically = worse asthma leading to more salbutamol. Treat = stop salbutamol. @ ICEM23
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@PEMDocSyd @DrMBarrett @TJCoats on a broader/adult perspective I think it also reinforces the message that ⬆️lactate doesn’t necessarily = shock/tissue hypoxia, need to consider underlying causes
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@DrMBarrett @TJCoats Yep. Us too…. Stopping salbutamol solves problem….. for some reason some pts quite sensitive and get lactic acidosis quite quickly
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Poster at #ICEM2023 new for me - Salbutamol associated lactic acidosis. Asthmatic patient increasingly breathless, lots salbutamol given. High lactate , no wheeze, normal/high pH.
Easy mistake clinically = worse asthma leading to more salbutamol. Treat = stop salbutamol. @ ICEM23

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@ACTINOSProject @ICEM23 @mr_astvad @cliffreid looks like this approach has now been (sensibly) retracted #icem2023
International Conference on Emergency Medicine@ICEM2025
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@ICEM23 @mr_astvad @cliffreid Presumably, not all speakers feel that way.
Maybe you could let us know which ones don’t want us to know about their work, and we could respect their wishes, and stop following them on platforms such as this?
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.@ICEM23 if you’re going to announce that all photos of slides at your conference are forbidden you need to say why. We are adults who have paid for an event with certain expectations. This is very unusual.
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Sri Lanka’s first ever #ILCOR full Task Force member . What an opportunity @Ilcor_org, @ERC_resus thank you 🙏🏾


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@PEMDocSyd @NarenGunja @RCollEM @TOXBASE @basl_events @WestSydHealth study ongoing across 3 Tox units in NSW looking at current regimen 20 hours v 12 hour regimen so you may see this change over next few years depending on results
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Following the work of an Expert Advisory Group our position statement on the use of the SNAP Regimen for the treatment of paracetamol toxicity has been revised to include adults & children @TOXBASE @basl_events.
See the statement here: bit.ly/3MYpQ6g
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@PEMDocSyd @RCollEM @TOXBASE @basl_events @NarenGunja I think the concept of aligning adult/paediatric regimens makes sense
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@LiangRhea Omg thank you. I’m so chuffed and pretty darned humbled after the intro @TraumaKate_Au gave re Prof McMahon. He sounded like an amazing friend and colleague. What a loss. I’ll try and do him proud. Even if I hate eating with my hands.
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Biggest congrats to @hardy_bm who has won the prestigious Damian McMahon Trauma prize this evening #RACS23, and will be off to the ATLS meeting later in the year. 👏🎉👏🎉

Rhea Liang@LiangRhea
The connections are DEFINITELY the best part of any conference. So wonderful to meet/ catch up with @hardy_bm @AyaBasam @BridgetClancy6 Dr Suellyn Centauri and @lisahadfieldlaw at #RACS23 🤗
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@Eleytherius Na+K+Ca2+Mg2+ all sing 🎤 to me…I call them the electrolyte orchestra…ELO for short 😃
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@j_stokesparish devastating news particularly after what happened in Tasmania last week 😔
thoughts with family, friends and work colleagues
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@DavidJuurlink @EMCases 🤔 …potential interactions with fentanyl and your favourite med tramadol 😄 in contributing to serotonin toxicity ?
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Crowdsourcing for a podcast with @EMCases: What drug interactions are EM physicians interested in hearing about?
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@sineadtaylor @SeanDreyer Yep 1st time ‘Dr Downes’ …..2nd time ‘Michael’ ….3rd time onwards ‘Downsey’……😄
#Straya
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@eapcct and methohexital a pro-convulsant barbiturate 😯 en.m.wikipedia.org/wiki/Methohexi… used it many years ago doing anaesthetics for ECT list
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Even though phenobarbital is used in the treatment of epilepsy & status epilepticus, seizures may be aggravated by phenobarbital overdose. seizure-journal.com/article/S1059-… 6/6
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Tox on the day! 1 January 1960. Death by accidental barbiturate overdose of American stage & film actress Margaret Sullavan. #toxontheday 1/6

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@JoeKennedyEM @NatGeo @toxiholic yep 👍
‘….who would keep a death adder as a pet when you could just have a labrador ? 🤷🏽♂️’ …Q from a colleague some time back whilst discussing a consult RE envenomed patient post bite from ‘pet’ snake 🐍
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My wife to me right now (watching @NatGeo snake documentaries for date night): “no. No. Gaboon vipers are NOT pets! Who would keep that as a pet?!?!?”
Hey @toxiholic — what say you?
GIF
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