Reflections & Resources from the RACGP QLD Clinical Update

I escaped the rock recently and spent the long weekend in Brisbane.  In addition to the usual mainland activities (eating out, shopping, attending the local cinema and more shopping), I attended the RACGP Qld Clinical Update. I often come home from conferences feeling reinvigorated and inspired, but I never end up collating or organising my notes and ideas into anything intelligible (let alone useful).  This year, IslandDocs has motivated me to share some take home messages from the conference, as well as a few clinical pearls that will likely change my practice (and hopefully will be useful for you as well).

My favourite take home messages

Geoff Toogood is a brave and inspirational man (and cardiologist), who I could have listened to all day.  He shared his personal journey dealing with depression and anxiety and he highlighted a few things that resonated with me:

  1. We need to get better at looking after ourselves and our colleagues
  2. We also need to normalise the conversation about doctors’ mental health
  3. Essentially our culture needs to change and it’s up to us to change it – our own lives depend on it

Continue reading “Reflections & Resources from the RACGP QLD Clinical Update”

Man vs the Monsoon

Note: The purpose of this site if to provide free open access medical education (FOAMed) in the context of rural and remote health. Though all stories have been inspired by real cases, all identifying details such as names, ages, locations and background descriptions have been thoroughly changed to ensure the absolute privacy of the patients, families and communities we serve.

The Situation

The monsoonal rains had been keeping most people indoors, the storm had been roaring and the seas were rough. The soon-to-be-patient was a 45 year old Australian crew member working on a Chinese container ship passing through the northern Torres Strait. He had been soaked by the storm while attempting to secure a dinghy to a pilot boat that was traveling with the main ship. On his approach to the boat a large wave washed over the dinghy and tipped it backwards and then upside down into the ocean while the motor was running. The man was dragged underneath the dinghy. He attempted to surface, but came up against resistance of the hull of the pilot ship. Disoriented, he dove again, trying to find a way to the surface and avoid the hazards of the propeller and other boat.  Eventually he surfaced with air above him and whilst being tussled in the waves grabbed onto one of the tires hanging from the pilot boat. He held on tightly to the tire as the wave crashed over him. Sometimes the waves went over his head, he swallowed water and he gasped for air. The sole crew-mate with him was unable to pull him back on board. Continue reading “Man vs the Monsoon”

Preventative Medicine: Healthy Kai Kai & Deadly Exercise

As primary healthcare doctors we have the privilege of educating and promoting good health amongst our patients. We know that preventive medicine is essential in reducing the morbidity and mortality of chronic disease including the most commonly seen here in Torres Strait Islanders: cardiovascular disease, diabetes and chronic kidney disease.

How do you promote healthy eating and physical activity with your patients? We would love to hear from you! Sent us a tweet @Island_Docs

Continue reading “Preventative Medicine: Healthy Kai Kai & Deadly Exercise”

The Pressure Is On: Will Australia Adopt New Hypertension Guidelines?

The Evidence:

A randomised trial of intensive versus standard blood-pressure control

The Summary:

The SPRINT trial was a randomised, controlled trial comparing the safety and efficacy of intensive lowering of systolic blood pressure (SBP) to less than 120mmHg, compared with standard management to less than 140mmHg. The study included a total of 9361 patients,  who were eligible to participate if their age was greater than, or equal to, fifty years and had hypertension with a SBP greater than 130mmHg. Exclusion criteria included those patients with diabetes mellitus, previous stroke and/ or end stage renal disease. Continue reading “The Pressure Is On: Will Australia Adopt New Hypertension Guidelines?”

A 7-year-old boy with Omnipresent Oedema

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

A 7-year-old boy presented to the Primary Healthcare Centre one afternoon after school with his grandmother. She was concerned that his eyes had become quite puffy over the past few days. He had been swimming at the local pool over the weekend and she thought it might be because he had been wearing swimming goggles. He denied any pain around his eyes, diplopia or blurred vision. He also noticed that his school shoes hurt when he put them on. Continue reading “A 7-year-old boy with Omnipresent Oedema”

The Flying Death Adder

Note: The purpose of this site if to provide free open access medical education (FOAMed) in the context of rural and remote health. Though all stories have been inspired by real cases, all identifying details such as names, ages, locations and background descriptions have been thoroughly changed to ensure the absolute privacy of the patients, families and communities we serve.

The Situation:

The school day had ended, and dusk was approaching on one of the pristine islands in the Torres Strait.  A 10-year-old girl and her friends were slowly making their way home when they came across a death adder on the road. The group armed themselves with sticks and approached the snake. Making a game of it, the snake was flicked into the air with a stick and landed on the road again. On the second throw, the snake was inadvertently hurtled directly at the girl by her twin brother. Its fangs collided with her index finger of her open hand leaving one tooth lodged in the pulp.

Continue reading “The Flying Death Adder”

Iron Deficiency Anaemia

As we improve our preventative health screening practices in Remote Indigenous Health we inevitably encounter incidental abnormalities in routine pathology. Given our limited resources and developing recall systems, what do we do about them?

The ABS report that remote indigenous populations are 2-3 times as likely to suffer from anaemia compared to their urban counterparts. A prevalence of greater than 5% is considered by the World Health Organization to be of public health significance. Childhood iron deficiency anaemia has been reported as high as 90% in some remote communities and has been associated with cognitive and psychomotor delay.

Two 20-year-old Males with Impending Sense of Doom

 

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity.

History

It was a quiet afternoon in the Emergency Department when a call came from the Ambulance Office informing us of 000 call from a boat out on the reef. “We’ve been told told that there are two young men out there who are both unwell and feel like they are going to die.” We didn’t receive much more information than that, and waited until a helicopter went to retrieve them, where they were both winched from the ocean. Continue reading “Two 20-year-old Males with Impending Sense of Doom”

24 Hours as the On-call Doctor in the Torres Strait

 Note: The purpose of this site if to provide free open access medical education (FOAMed) in the context of rural and remote health. Though all stories have been inspired by real cases, all identifying details such as names, ages, locations and background descriptions have been thoroughly changed to ensure the absolute privacy of the patients, families and communities we serve.

24 Hours as the Doctor On-call in the Torres Strait

Manning the on-call phone for the Torres Strait is one of my favourite jobs. There is a doctor rostered to this job at all times and entails being the first point of call for any medical query in the region.

The Background

The Torres Strait is a spectacular group of remote islands located at the very tip of Queensland between Cape York and Papua New Guinea. The most northern islands are only 4km offshore from the PNG mainland. The region spans 48,000 square kilometres, which is an area bigger that Switzerland or Holland, and is comprised of 274 islands though only 17 are inhabited. The Northern Peninsula Area (NPA) comprises five communities on the northern tip of Cape York Peninsula. The population of approximately 14,000 are spread over the Torres Strait islands and communities in the NPA. Continue reading “24 Hours as the On-call Doctor in the Torres Strait”