Afleveringen
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Description:
In this episode, an 11-year-old boy arrives unconscious, seizing, with a temperature of 40°C and tea-coloured urine. He was treated for malaria for four days. Now his kidneys are failing, his pressure is dropping, and the clock is running out.
In this real-life case review, Dr. Ann Kaguna Imelda (who managed the case) and Dr. Kenneth Bagonza (EM expert) walk through every critical decision—what worked, what didn’t, and why the child was unfortunate in the end.
special credit: Dr Daniel Oriba Longoya
Key points of discussion:
· The red flag triad
· Primary survey findings: threatened airway, shock, GCS 6
· Why dextrose has no role in septic shock resuscitation
· CSF Gram-positive diplococci = pneumococcal meningitis – treat immediately
· Managing hyperkalemia + AKI in a crashing child
· The 1-hour sepsis bundle (2026 guidelines)
· qSOFA at the bedside: RR ≥22, altered mental state, SBP ≤100 – no equipment needed
· Why “malaria not improving in 48 hours” demands a rethink
· Final reflection: system failures, early recognition, and what we owe the next child
Listen to learn. Share to save lives. Mastering Emergency Care
Disclaimer: For Educational Purposes only, refer to guidelines for definitive management
Show Notes & Resources:
· Watch the Full Case Video: https://youtu.be/qZZ86tknD8k?si=Pczbbe-vqvcti80V
· Rosen’s Emergency Medicine
· Tintinalli’s Emergency Medicine
· SSC 2026
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Description:
In this episode, an 11-year-old boy arrives unconscious, seizing, with a temperature of 40°C and tea-coloured urine. He was treated for malaria for four days. Now his kidneys are failing, his pressure is dropping, and the clock is running out.
In this real-life case review, Dr. Ann Kaguna Imelda (who managed the case) and Dr. Kenneth Bagonza (EM expert) walk through every critical decision—what worked, what didn’t, and why the child was unfortunate in the end.
special credit: Dr Daniel Oriba Longoya
Key points of discussion:
· The red flag triad
· Primary survey findings: threatened airway, shock, GCS 6
· Why dextrose has no role in septic shock resuscitation
· CSF Gram-positive diplococci = pneumococcal meningitis – treat immediately
· Managing hyperkalemia + AKI in a crashing child
· The 1-hour sepsis bundle (2026 guidelines)
· qSOFA at the bedside: RR ≥22, altered mental state, SBP ≤100 – no equipment needed
· Why “malaria not improving in 48 hours” demands a rethink
· Final reflection: system failures, early recognition, and what we owe the next child
Listen to learn. Share to save lives. Mastering Emergency Care
Disclaimer: For Educational Purposes only, refer to guidelines for definitive management
Show Notes & Resources:
· Watch the Full Case Video: https://youtu.be/qZZ86tknD8k?si=Pczbbe-vqvcti80V
· Rosen’s Emergency Medicine
· Tintinalli’s Emergency Medicine
· SSC 2026
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Zijn er afleveringen die ontbreken?
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In this episode, we walk through a high-stakes emergency: a 53-year-old woman with known hypertension who collapses at home, seizes, and arrives at the ED with a GCS of 8 and a blood pressure of 209/120 mmHg.
Join your hosts Dr Daniel Olinga and Dr Emmanuel David Okumu, along with special guests Dr. Brian Twinemastiko and Dr. Ruzige Bashir
Rashid, as we explore the critical, real-world decisions made when the textbook meets
reality.
We Discuss
· How to build and narrow a differential for altered mental status
· Why dropping BP too fast can cause a stroke
· The pathophysiology of PRES (Posterior Reversible Encephalopathy Syndrome)
· Practical management in a resource-limited setting like Uganda
· Key pitfalls: oral antihypertensives, missed pulmonary edema, and nutrition neglect
Tune in to learn how to manage Altered Mental Status secondary to Hypertensive Encephalopathy a pragmatic approach.
Disclaimer: For Educational Purposes only, refer to guidelines for definitive management
Show Notes & Resources:
· Watch the Full Case Video: https://youtu.be/qZZ86tknD8k?si=Pczbbe-vqvcti80V
· Rosen’s Emergency Medicine
· Tintinalli’s Emergency Medicine
· BMJ 2024: Evaluation and Management of Hypertensive Emergency
· PubMed: 40818477, 10972386
· NEJM: 1990;323(17):1178–1184
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In this episode, we tackle this exact nightmare scenario, breaking down a recent CPC case of
a polytrauma patient who develops ARDS. Join your hosts Dr Daniel Olinga and Dr
Emmanuel David Okumu, along with special guests Dr. Ambrose Okello and Dr. Umar
Rashid, as we explore the critical, real-world decisions made when the textbook meets
reality.
We discuss:
The Case: A rapid recap of the 48-year-old male patient, day 5 post-RTA with rib, femur, and mandible fractures, and his sudden respiratory decompensation.Defining ARDS Without Resources: Why the classic Berlin Definition fails us and how the Kigali Modification (using SpO2/FiO2 ratios and POCUS) allows for a clinical diagnosis of ARDS without a ventilator or ABG.The Management DilemmaGlobal vs. Local RealityVentilation: Low Tidal Volume ventilation in the West vs. Awake Proning on High Flow Nasal Cannula (HFNC) in Uganda.Monitoring: Daily CT scans vs. Lung POCUS to instantly differentiate edema from pneumothorax.The Silent Killers: Why DVT prophylaxis is critical, why Tramadol isn't enough for pain, and the often-overlooked reality of nutrition—how a mandible fracture can lead to death from hypoglycemia if an NG tube isn't placed and the family isn't educated on liquid feeds.Tune in to learn how to treat ARDS with what you have: Oxygen, positioning, ultrasound,
and a pragmatic approach.
Disclaimer: For Educational Purposes only, refer to guidelines for definitive management
Show Notes & Resources:
· Watch the Full Case Video: https://youtu.be/qZZ86tknD8k?si=Pczbbe-vqvcti80V
· The Kigali Modification: Riviello et al. (2016) - Diagnosing ARDS without ABGs or
Ventilators.
· ARISE-AFRICA Protocol: Recent trials on CPAP/HFNC in African settings.
