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...

Magnesium for leg cramps…just as good as placebo?

Clinical question: does magnesium work for leg cramps? Findings 1: Cochrane review, 2012 Both magnesium & placebo reduce the frequency of leg cramps with a non-significant difference between the two groups.  The Cochrane review analysed four RCTs (n=322), two of which were deemed to have a high risk of...

A 62-year-old Male with Dreadful Dysuria

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity. History A 62-year-old Male trudged into the Emergency Department on a Friday night. There was a downpour of rain outside as the wind was whistling through the windows and...

Incidental Eosinophilia

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?  Over the next few weeks we will address a handful of common queries and a...

Urinary incontinence

Island Docs are generalists.  We strive to maintain a breadth of knowledge rather than focus on a particular specialty field.  In our efforts to provide high quality patient care, we work hard to keep up to date with the latest evidence and guidelines.  We are lucky to receive regular...

Week 6.1 – Sepsis

What is it? Sepsis is defined as life-threatening organ dysfunction secondary to an infection. Early recognition and early management of sepsis is critical. Sepsis kills more than breast or prostate cancer here in Australia. Have a look at this great summary video from JAMA on defining sepsis and septic...

A 25-year-old Female with a Mysterious Myalgia

This case has been inspired by events in the Torres Straits and details have been changed to ensure patient anonymity. History A 25-year old previously well female presented to the remote area nurse on an outer island somewhere in the Torres after being carried into the clinic by her...

Week 5.1 – Non Invasive Ventilation

CPAP and BIPAP can be daunting to commence if you’re not familiar with your emergency department equipment. This week we get started with our NIV machine – the Oxylog 3000. Having a dedicated BIPAP machine is somewhat of a pipe dream for our ED, but on the bright side...

Week 4.1 – Chest Pain Emergencies

This week we explore the variety of chest pain emergencies that present to our Emergency Department via ambulance, dinghy, helicopter or even sometimes by bicycle. Taking a targeted chest pain history and performing an efficient examination is a skill that develops over time. This skill is essential, particularly in...

Professional Burn Out – Am I Enough?

Behind every committed professional is the quietly disconcerting question “Am I enough?” Our profession is full of them; harm avoidant, reward dependent, goal orientated individuals.  However in remote practice, these effective traits can lead to frustration and burn out.  Supporting systems are still in development, recruitment and retention is...