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Snake Bites
In the UK approximately 100 people are envenomated by a snake each year.
So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).
- Don’t Cut & Suck!
- Treat what you see
- Call Toxbase
Measles
Suspected/Confirmed patients should be ISOLATED & wear PPE
Treating Staff – (should not be; non-immunised, pregnant or immunocompromised)
- single-use, disposable gloves
- single-use, disposable apron (or gown if extensive splashing or spraying, or performing an aerosol generating procedure (AGP))
- FFP3 – respiratory protective equipment (RPE)
- eye/face protection (goggles or visor)
Patient
- Surgical face mask
Background
- Measles is highly infectious – (4 day prior to and after rash appears) suspected patients should be isolated within the ED
- Measles Immunisation – 1 dose 90% effective, 2 doses 95% effective
- Measles is a notifiable disease
Bilary Disease
Gallstones are common, with a prevalence of approximately 10–15% of adults in Europe and the U.S. Most of the time patients are asymptomatic. but there are several ways gallstone disease can present.
Rhabdomyolysis
We often worry about patients developing rhabdomyolysis and consequently developing AKI. However, there is much debate and little consistency in the published data, over how to diagnose and who needs admission to treat. So its important to consider both clinical context along with laboratory values
Rape & Sexual Assault
Don’t
Preform intimate examinations on Sexual assault/Rape patients
- Unless life-threatening injuries are suspected e.g Haemorrhage.
- As our examination will inevitably destroy evidence that may aid this patient’s case
Do’s
- Consider contamination injury (HIV, HepB, HepC) – Guide
- Consider emergency contraception
- Children must have police referral for safeguarding and discussion with social care. The paediatricians in CHT may be able to offer support in navigation of services but the responsibility for non-urgent medical assessment lies with specialists at SARC.
- Refer to The Sexual Assault Referral Centre, either via Police or Self referral
Hypocalcaemia
Hypocalcaemia can life threatening, due to arrhythmias and seizures.
Severity – Adjusted Calcium (Ca)
- Mild: >1.9mmol/l
- Severe: ≤1.9mmol/l OR Symptomatic
Chest Trauma – WYMTN
Chest injury as part of major trauma, can range from painful to life threatening so prompt treatment and recognition is vital. Esp. in ‘Silver Trauma’ when ‘minor’ injuries may have devastating consequences – the full guidance can be found @WYMTN – HERE
Civility Saves Lives
Emergency Medicine is a challenging environment, balancing patient needs, time constraints and systems pressures. When this intensifies as responsible clinicians we can ALL feel frustrated, and this can lead to Rudeness. Which, far from rectifying the issues has been show to only exacerbate the issues.
FERNO Traction Splint
How to apply the FERNO traction splint for our in-hospital patients
