Category: Medical

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
EM3

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Headache

There are numerous causes of headache, however, the pressing question in the ED is,

Is this a primary or SECONDARY headache?

  • Primary headaches [e.g. tension & migraine}, maybe painful and need analgesia but don’t require emergency investigation.
  • Secondary headaches, often but not always have serious underlying causes [e.g. SAH, central venous thrombosis] requiring emergent investigation and treatment

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Delirium in the ED

Delirium is one of a number of geriatric syndromes and has significant associated morbidity and mortality.

3 subtypes of delirium

  1. Hyperactive – easies to spot, one we are most familiar with. Characterised by agitation/aggression/hallucinations “the non cooperative patient”
  2. Hypoactive – harder to spot. Characterised by drowsiness, less responsive, vacant, sleeping more at home
  3. Mixed

Remember there is NO SUCH THING AS A “POOR HISTORIAN” !! – Just a poor clinician! If your patient is not cooperating and can’t tell you very much then you need to find out why!!! Read more

Hypothermia

Remove COLD, Add WARM, Don’t SHAKE

  • 32-35ºC [Mild] – Shivering, Tachycardia, Tachypnoeic, Vasoconstriction
  • 30-32ºC [Moderate] – Shivering stops, Pale/Cyanosed, Hypotensive, Confused, Lethargic
  • <30ºC [Severe] – Low GCS, Bradycardia/pnoeic, Hypotensive, Arrhythmias, Cardiac Arrest

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Pneumonia (Community Acquired)

Severe Pneumonia: Please Request/Send – Samples Sputum/Blood/Urine

BTS Definition of CAP

Signs of acute Lower Respiratory Tract illness (LRTI) [Cough] &:

  •  ≥1 other LRTI Symptom [Pleuritic pain, Tachypnea, Dyspnea, etc]
  • New Focal Chest Signs [Creps, Bronchial breathing, Red. A/E]
  • ≥1 Systemic sign [Fever, Sweats, Chills, Rigors, >38oC]
  • New CXR changes [if hospitalized]

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