Are You CO Aware?

October 24, 2018

With the onset of colder weather, many households in the UK are turning on their heating for the first time in months. Heating appliances need… Read more

Assessing Functional Leg Weakness

November 21, 2020

When patients present with functional symptoms. It can be difficult to discern whether if it is an actual or functional weakness. And it can be… Read more

Bell’s Palsy

May 2, 2018

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 (Carotid OR Vertebral) Artery Dissection

November 24, 2018

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

Dabigatran Reversal

September 16, 2019

Bleeding on Dabigatran? <C>ABCD – as usual trying to stop bleedBloods: FBC, Clotting, U&E, G&SDiscuss with Haematologist (esp. if taken within 12-24hr)Idarucizumab (PRAXBIND) 5g IVFound… Read more

Delirium in the ED

March 11, 2019

Delirium is one of a number of geriatric syndromes and has significant associated morbidity and mortality. 3 subtypes of delirium Hyperactive – easies to spot,… Read more

DVLA – Driving & Medical Conditions

May 8, 2018

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

Giant Cell Arteritis – GCA

March 13, 2018

GCA is a is a vasculitis generally seen in the over 50’s and associated with polymyalgia rheumatic (PMR). However, unlike a lot of rheumatology, GCA… Read more

Head Injury

February 27, 2018

Background Defined as any traumatic injury to the head other than superficial facial injuries. The commonest cause of death and disability in people age 1-40… Read more


February 27, 2018

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


December 11, 2019

Classification Normal: 1.1-0.7 Mild: 0.69-0.5 Moderate: 4.9-4.0 Severe: <0.4 Signs/Symps (normally <0.5) MSK: Muscle Twitch, Tremor, Tetany, Cramps CNS: Apathy, Depression, Hallucination, Agitation, Confusion, Seizure… Read more

Meningitis – Adults

December 16, 2017

  Keep your suspicions high – early signs it may not be clear Sepsis Kills – give antibiotics & fluid early Consider Acyclovir Give Dexamethasone with… Read more

MRI Questionnaire

March 21, 2018

When we need to book an MRI e.g. for Cauda Equina, we need to print the MRI Questionnaire and complete it! Although, most of this… Read more

Octaplex – work fast its an EMERGENCY!

December 16, 2017

In recent incidents we have had significant delays in giving OCTAPLEX, So ….. Activate EARLY in head injury patients on warfarin. Order on EPR &… Read more

Ottawa SAH Rule

June 27, 2019

Headache is a common presentation to ED and Subarachnoid is the diagnosis we never want to miss. However, working out who needs a scan can… Read more

Parkinson’s Disease & can’t swallow

October 2, 2019

We all recognise the importance of ensuring patients with Parkinson’s disease (PD) get their medication, but.. What do you do if the patient can’t swallow?… Read more

Primary Intracerebral Haemorrhage

December 1, 2020

In anybody who there is suspicion of a non-traumatic haemorrhage arrange an urgent CT Head. All patients need IV access and  U&E, FBC, Coag If… Read more

Proximal Myopathy/Muscle Weakness

May 1, 2018

The Case An elderly patient attends the ED with difficulty mobilising, Nursing staff tell you that the patient needs a CT head for STROKE? –… Read more

Purple Glove Syndrome – Case

September 23, 2018

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

RCEM CPD 2019 Day 1

April 2, 2019

 HEAD AND NECK Tracheostomy Emergency Care – Dr Brendan McGarth Needs to distinguish Tracheostomy from laryngectomy as a laryngectomy has no connection to the… Read more

RCEM CPD 2019 Day 2

April 3, 2019

NEUROLOGY #RCEMcpd  @RCEMevents Advances in Acute Stroke Intervention  Dr Ian Rennie Acute Stroke Thrombolysis only recannulates approximately 10% of large vessels. MR CLEAN trial reduced… Read more

Stroke – BE FAST

January 12, 2021

As we know “TIME is BRAIN” so early recognition of stroke is vital so BE FAST! Read more

Syncope – ESC 2018

September 25, 2018

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

Tick-Bourne Diseases

August 6, 2020

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… Read more

Vertigo in ED

December 20, 2017

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… Read more