The prevalence of diseases transmitted by tick bite have increased in recent years, within the UK. And it is now recognised that there are 3 main infections
- Lyme Disease
- Tick-Bourne Encephalitis
- Babesia
Category: Learning
Hyperemesis Gravidarum
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 pathology
- Infections
- Drug History
- Chronic H.Pylori
Animal Bites – Mammalian
Dog, and other mammalian bites, are a common presentation with the ED.
They can be easy to treat, but need some particular attention if we are going to get them right.
AKI – Acute Kidney Injury
AKI is a common issue for patients presenting to the ED and not only has a significant mortality associated with it but also a massive cost to the NHS. Early recognition and treatment can improve outcomes. Read more
Alcohol Withdrawl
Generally we DON’T admit patients acutely solely for “Detox”
However the following groups should be admitted [taken from trust guide]
- Patients requiring admission for another reason – refer to appropriate specialty (e.g. Head injury going to CDU, or Upper GI bleed going to medicine)
- ALL patients with symptoms / signs of Wernicke’s – medicine
- ALL patients with Delirium Tremens – medicine
- ALL alcohol withdrawal fits if patient to remain abstinent – medicine
- ALL alcohol related seizures with possible other trigger – medicnie
- ALL decompensated alcoholic liver disease – medicine
If admitted to CDU – complete the PAT tool
Nail Trephination
Bleeding under the nail from blunt trauma can be very painful. Lucky we have the tools on hand to ease some of that pain.
Burns Referral Pathway
A new burns referral pathway has been developed with Mid Yorks to securely send images of the patients burn. Allowing the burns team to arrange the most appropriate follow-up for your patient.
This requires BOTH online referral & phone call
The Process
- GoTo – Burns Homepage (NHS computers ONLY)
- Select – New Referral (NO login required)
- Complete – the following sections (* means required field)
- Referrers Details – you will need an NHS email address
- Patient Details
- Injury Details – Answering “Yes” to airway burns or fluid resuscitation will open further boxes
- Additional Details – Patient’s phone number and address (only appears if NO airway or resuscitation issues)
- Checklist – Ensure ALL completed and submit
- Sending an Image – After submission a QR code will appear to send an image you will need to us the SID App
- Launch the SID App on mobile device – Yours or ED Co-Ordanator (apple/android)
- Scan the QR code
- Consent the patient – Patient Information Leaflet
- Take Photo of Injury – this will not be saved on the device
- Phone Burns team – They can review the details and images and better advise you on management.
Resources
Achilles Tendon Rupture
A common sporting injury, especially in disciplines that require stop start sprints or rapid changes of direction
Proximal Myopathy/Muscle Weakness
The Case
An elderly patient attends the ED with difficulty mobilising, Nursing staff tell you that the patient needs a CT head for STROKE? – “They are really unsteady if they try to stand and they can’t lift their arms up”. Read more
Cervical (Carotid OR Vertebral) Artery Dissection
Cervical artery dissection is a rare but significant cause of stroke and headache/neckache, which is easy to overlook. Leading to a typically delay in diagnosis of 7 days. Unfortunately imaging the cervical arteries is not simple, with MRA being the method of choice. Hence these patients must be referred to the “Stroke Consultant”.
