Dr Stuart McLay

Stuart McLay became a FACEM in 2019 and is currently completing CICM training and holds a Grad Cert in International Public Health. He has published a few papers and is curious about almost everything. With that, an absolutely incredible wife, and 2 small kids there's not much time for other stuff, but if there were, Stu would be riding his motorbike or be off hunting somewhere with mates. (ORCID https://orcid.org/0000-0003-0867-1629)

DIAGcalc: Stephen Smith Anterior OMI Score

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Stephen Smith 4-Variable OMI Calculator Score: 0.00 Interpretation: Unlikely LAD occlusion. Formula: (1.062 × STE 60 ms) + (0.052 × QTc) − (0.151 × QRS in V2) − (0.268 × R-wave in V4) Reference: Driver BE, Khalil A, Henry T, Kazmi F, Adil A, Smith SW. A new 4-variable formula to differentiate normal variant ST … Read more

Calculator: Opioid Equivalence

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Opioid Equivalence Calculator Opioid Equivalence Calculator Oral Morphine Dose mg (per day) Preparations IV/IM/SC Oral Sublingual Transdermal Rectal IV/IM/SC preparations Fentanyl (0.2): µg Sufentanil (2): µg Codeine (0.25): mg Hydromorphone (15): mg Morphine (3): mg Oxycodone (3): mg Pethidine (0.4): mg Oral preparations Codeine / Dihydrocodeine [0.1–0.15] (0.13): mg Dextropropoxyphene (0.1): mg Hydrocodone (1): mg … Read more

Exquisite etymology

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Every now and then I come across weird words. Not just medical, mind, every subject. I figure I’ll put them in this little jar and come back once in a while to shake it and smile. Aglet: (noun) a metal or plastic tube fixed tightly round each end of a shoelace.

PHYScalc: Sodium

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Let’s start with the Adrogué–Madias (A-M) formula (1997): Na+ deficit = TBW fraction x weight x ΔNa+ Sodium Deficit Calculator Sex Male (0.6)Female (0.5) Weight: 80 kg Starting [Na+]: 110 mmol/L Target [Na+]: 115 mmol/L Sodium deficit = ksex × Wt × Δ[Na+] = 150 mmol Glucose-adjusted Sodium Calculator Glucose-adjusted Sodium Calculator Measured [Na+] 115 … Read more

Calculator: Total Body Water

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Choose your favourite formula (60/50 is my default for adults) 60/50 Watson Hume-Weyers Mellits-Cheek (paeds) Age: 18 years Height: 90 cm Weight: 70 kg Male Female Total Body Water: 42 L Intracellular Fluid: 23.1 L Extracellular Fluid: 18.9 L – Plasma volume: 2.8 L 60/50 is from the Report on the Task Group on Reference … Read more

Simple Molecule Size Searcher

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This is just to find out what molecules are the right size for what sort of extracorporeal removal, if at all. These weights are (mostly) just an approximation, especially as they get into the tens of thousands. Have a go. I found it interesting, hopefully you might, too. NB: Haemodialysis generally removes molecules <20kDa in … Read more

Enterocutaneous fistula

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The approach is graphically summarised here. It’s based on Alex Yartsev‘s awe-inspiring Deranged Physiology post, as well as  Cohen et al (2016),  Lundy & Fischer (2010) and Evenson (2016). The final decision-loop ignores the third possibility, which is that the patient is stable enough to go on living with a chronically-discharging ECF. I had to draw the line … Read more