Scombroid poisoning (AKA – Histamine fish poisoning) is apparently more common than we think and accounts for 40% of seafood related illness in the USA according to the CDC. But Scombriod poisoning is missed as its put down to allergy. Read more
Category: speciality
Adrenal Crisis
Adrenal crisis or insufficiency is a life threatening emergency due to the lack of glucocorticoid. Adrenal crisis can be primary due to destruction of the adrenal cortex (Addison’s), or secondary due to down regulation (chronic steroid use) Read more
Dental Abscess
Dental Abscess requires a Dentist for Definitive Treatment
Symptoms:
- Dental Pain
- Unpleasant taste
- Fever and Malaise
- Trismus
- Dysphagia
- Facial Swelling
- Regional Lymphadenopathy
- Tooth Decay
- Gum Swelling or tenderness
- Purulent Exudate
Vertigo in ED
Vertigo is not always labyrinthitis!! There are some potentially serious conditions to think about. Your main question should be is it peripheral [good] or central [bad]?

Methaemoglobinaemia
Q: Why are Smurf’s Blue?
A: Methaemoglobin (MetHb) of course!
– MetHb is produced by oxidisation of the Iron in Haemoglobin (Hb) from Fe2+ to Fe3+
– Fe3+ prevents Hb carrying oxygen (thus produces symptoms of hypoxia)
– Often due to chemical ingestion, but may also be genetic
– Treated with Methyl Blue & supportive measures
Hypernatraemia
Hypernatraemia is a not a common presentation in ED, as intense thirst often prevents significant hypernatraemia in neurologically intact individuals. So… Mortality rates are high (20-70%) and the severity of hypernatraemia has been shown be an independent predictor of mortality.
However, there is little good data on hypernatremia to base guidance on, and definitions vary within the literature
Retrobulbar haemorrhage
What is retrobulbar haemorrhage?
- Rapidly progressing haemorrhage into the retrobulbar space which is rare but potentially sight threatening.
- Retrobulbar haemorrhage causes a rapid rise in intraorbital volume and pressure.
- If not treated it can quickly lead to retinal ischaemia and infarction resulting in permanent visual impairment or complete visual loss.
PEARS
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
Epistaxis – Management
Nose bleeds are a bloody common problem (bad pun intended) – most originating at the front to the nose where there is a cluster of blood vessels – Little’s Area.
In the young the bleeding often starts after trauma (e.g. picking or punching noses). In the elderly however, it is commonly a manifestation of underlying vascular disease. Read more