Nausea and vomiting in pregnancy is common and at best an unpleasant experience for the patient, and at worst can be life threatening. It normal starts @ 4-7/40, peaks @ 9/40, and finishes @ 20/40. We need to conduct a thorough history and examination looking for causes other than a high βHCG. these include: Abdominal pathology Urinary …
Pulmonary Embolism in Pregnancy
Unfortunately the the normal pathway for investigation of PE performs poorly in pregnancy RCOG have the following pathway 1. Investigation – of suspected PE Clinical assessment – its all on the history and exam scoring doesn’t work Perform the following tests: CXR – sheilding can protect the baby and may avoid further radiation ECG Bloods: FBC, …
EMBRACE & Paediatric Critical Care
In our trust we don’t have paediatric critical care beds. However, in our region we use EMBRACE (a paediatric critical care transport team), who can transfer critically ill children to specialist centers (in or out of region). EMBRACE 0114 268 8180 Guidance Y&H Paed Critical Care Guidance
Be #urosceptical
Ditch the Dipstick – for patients >65Yrs or Catheterised! Approx. 50% of over 65’s and most of those with catheters have asymptomatic bacteriuria. The patient will not benefit from treatment and often gives us premature closure (i.e. we blame a fictitious UTI for the patients symptoms and stop thinking).
Ottawa SAH Rule
Headache is a common presentation to ED and Subarachnoid is the diagnosis we never want to miss. However, working out who needs a scan can be difficult as 50% of patients presenting with a subarachnoid have no neurological deficit. The Ottawa SAH Rule is a validated tool for deciding who needs as CT scan. …
Neck of 5th Metacarpal Fractures
Neck of fifth Metacarpal (Boxer’s) fractures are a common injury, and how we treat them locally is changing.
Protected: CRH SitRep Summary
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Protected: CRH SitRep
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Epistaxis – ACP/MG Teaching
Slide set – HERE Main topics Anatomy Cautery Packing – Don’t force it call for ENT help (septal deviation or spurs) Remember – Elderly patients can have devastating posterior bleeds call ENT early Kindly presented by Mr Habib
Paediatric Sepsis Podcast (RCPCH)
RCPCH have released a GREAT series of podcasts on paediatric sepsis. It is from a paediatric slant, but is applicable to the ED and well worth a listen [For Docs and Nurses]
