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Very few of us come to work intent on doing harm. However, despite that we all keep making mistakes. Most of them pass unnoticed and… Read more

A-a gradient = Alveolar Oxygen – arterial Oxygen This is “relatively” simple way of working out if the paO2 on a ABG is normal, and demonstrates… Read more

Most of us will have seen patients like this – agitated, aggressive and often with police or security pinning them down. High risk of Cardiovascular… Read more

  AHF Triggers there are many triggers for AHF, which if recognized and treated with help improve outcomes Cardiac: ACS, Arrhythmia, Aortic Dissection, Acute Valve… Read more

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… Read more

Aortic Dissection (AD), is uncommon (1 AD:200 ACS) but is…Rapidly FATAL!  Unfortunately recognising aortic dissection is difficult with a clinician pickup rate of 15-43%. Read more

Asthma is common and potentially fatal. Severity – Severe or Life threatening – think RESUS Treatment within 30 min – bronchodilators and steroids should bee… Read more

Bell’s Plays is a lower motor neurone (LMN) lesion of the facial nerve (CN VII), which causes one side of the face to “droop” [1%… Read more

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… Read more

COPD patients vary widely, due to their comorbidities, social circumstances, and wishes. So choosing the best treatment pathway for the patient can be complex. Involve… Read more

Things to remember Give NaCl 0.9% Actrapid “Fixed Rate” 0.1unit/kg/hr Basal Insulin (lantus/levemir) give this too – usual time and dose Potassium – if below… Read more

For many conditions the patient should be informed to stop driving and inform the DVLA of their condition. It is the patients responsibility to inform the… Read more

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… Read more

Patients sometimes present to ED or are send to ED due to over anticoagulation with warfarin 1. Is there Major/Significant bleeding? Yes Resuscitate (ABCD) Give… Read more

Remember: is it a haemolysed blood sample? (you can do an iSTAT) Severity Mild: 5.5-5.9mmol/l – No urgent action required (Dietary & Medication modification &… Read more

HHS (A.K.A. HONK) is a diabetic emergency, but unlike DKA we don’t always think about it. Patients with HHS are often elderly with multiple co-morbidities,… Read more

Hypoglycaemia (Blood glucose under 4.0 mmol/l) is potentially fatal and should be treated. it may be defined as “mild” self-treated, or “severe” treated by a… Read more

Hypokalaemia (low potassium), is a common problem. It is found in 14% of outpatients and 20% of inpatients, however only 4-5% of those are of… Read more

In the case of patient with Massive Haemorrhage weather that be from Trauma, Surgical, O&G, UGIB, you can activate the MTP Remember: Do the Basics… Read more

This is guide to the investigation of Metastatic Spinal Cord Compression (MSCC) in Oncology/Haematology patients. You need to be a bit more suspicious and have a… Read more

PPCI Target: Door to balloon 90min Criteria: Time: Chest pain within 12hrs (or worsened within 12hrs) ECG:  ST elevation MI (1mm Limb or 2mm Chest… Read more

Often patients with cellulitis, need more than oral antibiotic management. However, they are not so sick to require hospital admission. OPAT allows suitable patients to… Read more

To drain or not to drain – that is the question (Follow the BTS algorithm).This is not for Tension! Suggestion: Large pneumothorax consider placing a Seldinger drain… Read more

Before you start treating make sure you ask a few question Questions Whats the cause? – treating the precipitant often sorts the AF (adding B-Blockers… Read more

Is a rare complication of I.V. Phenytoin, which presents with a triad of: Pain, Oedema & Discolouration, typically in the hand. In our case a… Read more

Recent Incident: Bat contact was not recognized (effectively touching a bat without gloves means treatment is recommended) Rabies is an acute viral encephalomyelitis caused by members of… Read more

Background Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs. Sepsis can lead to… Read more

Our video maybe light hearted but… SEPSIS is a Killer (1:4 Die)  and time matters Recognise, Resuscitate, Review  Read more

Background Acute sore throats are often caused by a virus, last about a week and get better without antibiotics. withholding antibiotics rarely causes complications. Antibiotic… Read more

Defintion:Transient Loss of Consciousness (TLOC) due to cerebral hypoperfusion, characterised by a rapid onset, short duration, and spontaneous complete recovery. Common ED Complaint: 1.7% of all attendances Difficult… Read more

Background Cardiac arrhythmias are relatively common presentations to ED. There are many causes, some more sinister than others. If your patient is not acutely unwell… Read more

Not normally difficult to spot, but look for it in unexplained anaemia, or collapse. Questions Is it VARICEAL? Mortality 35%, so is an emergency whatever… Read more