Urgent Bite 274 - Thinking about ECG artefact

Pisa syndrome is rare, but identifiable in urgent care and associated with drugs we will commonly see.  It is a reversible condition.  It highlights the importance of a full drug history and to consider medications as causes of strange symptoms.     Check out the Prescriber Update, Vol 46, No 3, September 2025 Check out the paper mentioned - Link Pitton Rissardo J, Murtaza Vora N, Danaf N, Ramesh S, Shariff S, Fornari Caprara AL. Pisa Syndrome Secondary to Drugs: A Scope Review. Geriatrics (Basel). 2024 Jul 30;9(4):100. doi: 10.3390/geriatrics9040100. PMID: 39195130; PMCID: PMC11353465.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor 

We should be aware of the early signs of ocular siderosis, also known as siderosis bulbi which would indicate a retained metallic intraocular foreign body.     Check out the Stat Pearls page. Acharya I, Raut AA. Siderosis Bulbi. [Updated 2023 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor 

Dr Ceri Battle is a Consultant Respiratory Physiotherapist and an Honorary Associate Professor in Swansea.  Ceri's PHD work led to the creation of the STUMBL score, a tool to help determine the risk of complications for patients with rib fractures.    Following her pre-recorded talk to our Bootcamp, she discusses the STUMBL score on the podcast and answers questions that arose from her talk last month.   Check out the STUMBL Score on MD Calc   Check out some of Ceri's work Battle C, Hutchings HA, Driscoll T, O'Neill C, Groves S, Watkins A, Lecky FE, Jones S, Gagg J, Body R, Abbott Z, Evans PA. A multicentre randomised feasibility STUdy evaluating the impact of a prognostic model for Management of BLunt chest wall trauma patients: STUMBL Trial. BMJ Open. 2019 Jul 26;9(7):e029187. doi: 10.1136/bmjopen-2019-029187. PMID: 31350248; PMCID: PMC6661629.  LINK Battle C, Cole E, Carter K, Baker E. Clinical prediction models for the management of blunt chest trauma in the emergency department: a systematic review. BMC Emerg Med. 2024 Oct 12;24(1):189. doi: 10.1186/s12873-024-01107-6. PMID: 39395934; PMCID: PMC11470733. LINK    www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor 

Why is it called hypochondriasis, and why might it benefit our patients to identify cases and ensure proper follow-up and treatment? Check out the papers mentioned. Sunderland M, Newby JM, Andrews G. Health anxiety in Australia: prevalence, comorbidity, disability and service use. Br J Psychiatry. 2013 Jan;202(1):56-61. doi: 10.1192/bjp.bp.111.103960. Epub 2012 Apr 12. PMID: 22500013. link Florian Weck, Samantha Richtberg, Julia M.B. Neng, Epidemiology of Hypochondriasis and Health Anxiety: Comparison of Different Diagnostic Criteria, Current Psychiatry Reviews; Volume 10, Issue 1, 2014, . DOI: 10.2174/1573400509666131119004444 link Mataix-Cols D, Isomura K, Sidorchuk A, Rautio D, Ivanov VZ, Rück C, Österman S, Lichtenstein P, Larsson H, Kuja-Halkola R, Chang Z, Brickell I, Hedman-Lagerlöf E, Fernández de la Cruz L. All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis. JAMA Psychiatry. 2024 Mar 1;81(3):284-291. doi: 10.1001/jamapsychiatry.2023.4744. PMID: 38091000; PMCID: PMC10719832. link   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor 

Dr Fiona Moir and Dr Renske van den Brink are directors of Connect Communications.  They both have a background in General Practice and medical education, and they have extensive experience in teaching communication skills to students and experienced clinicians alike.   In Part 2, we consider wellness, burnout prevention, and Balint peer groups, as well as the importance of allocating some of your CPD towards communication-related activities.   Make sure you have listened to Part 1, in which we learn how they came to create Connect Communications, and we discuss why communications skills are important to all areas of our lives, not just our patient conversations.     Check out what Connect Communications offers on their website   If you are an RNZCUC member, you can access the communication suite of videos by following this link.   Link to the Balint Society of Australia and New Zealand.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor 

Dr Fiona Moir and Dr Renske van den Brink are directors of Connect Communications.  They both have a background in General Practice and medical education, and they have extensive experience in teaching communication skills to students and experienced clinicians alike.   In part one of this podcast, they tell us how they came to create Connect Communications, and we discuss why communications skills are important to all areas of our lives, not just our patient conversations.   In part 2, we will consider wellness, burnout prevention and Balint peer groups, as well as considering the importance of using some of your CPD towards communication-related activities.     Check out what Connect Communications offers on their website   If you are an RNZCUC member, you can access the communication suite of videos by following this link.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor       

For World Sepsis Month, we talk with Ally Hossain, whose son is a sepsis survivor.   What are the important lessons we can take from hearing her son's story so that we can pick up and refer suspected sepsis earlier?     Ally is now the Director of Communications and Engagement for the Sepsis Trust in New Zealand and a board member of the Global Sepsis Alliance.     Check out the Sepsis Trust NZ for more information, including pathways.   Check out the HQSC sepsis resources   Become a sepsis superhero by donating and helping to raise funds   Check out the Global Sepsis Alliance   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc   Music licensed from www.premiumbeat.com Billion Stars by Remember the Future   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor

September is World Sepsis Month.  Use this as a reason to explore some sepsis related CPD.   Check out the NZ Sepsis Trust website - https://www.sepsis.org.nz/   Become a Sepsis Superhero - https://stopsepsis.org.nz/   Register for the Webinar by Dr Paul Huggan     Register for the Global Sepsis Alliance Webinar   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

Do you see a Christmas tree when you see pityriasis rosea?   Check out the Dermnet page by Prof Amanda Oakley     www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor 

We should be aware of artefacts as a cause of error when interpreting an ECG.   Pérez-Riera AR, Barbosa-Barros R, Daminello-Raimundo R, de Abreu LC. Main artifacts in electrocardiography. Ann Noninvasive Electrocardiol. 2018 Mar;23(2):e12494. doi: 10.1111/anec.12494. Epub 2017 Sep 20. PMID: 28940924; PMCID: PMC6931710. Link   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor