REALISTIC EMERGENCY MEDICINE
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 disablED survivors following stroke from 53% to 29%. NNT <2 (New England Journal of Medicine 2015) Dawn trial showed treatment up to 24 hours from “last well” can produce significant …
HEAD AND NECK Tracheostomy Emergency Care – Dr Brendan McGarth www.Tracheostomy.org.uk Needs to distinguish Tracheostomy from laryngectomy as a laryngectomy has no connection to the upper airway however a tracheostomy may have a connection so gives you 2 options for an airway. Trachostomy problems commonly seen in the ED:- Tube obstructions Tube displacement Stoma problems …
Simple pre-intubation checklist for the whole team to be aware of so we can make intubation in ED as safe as possible. PDF: Full Version (included tracheostomy displacement algorithm)
Working out what your patient might have been vaccinated for can be tricky, and more so if they were raised outside of the UK. Luckily there are a couple of tools online you can use to make this easier.
Fracture Clinic is changing to Virtual Fracture Clinic (VFC) It’s been found that 30% of patients referred to fracture clinic where discharged with only advice and guidance it was also found that another 30% of patients could have had a more appropriate first appointment and avoid multiple attendances.
Ligature cutters are keep at the Nurse-in-Charges station Remember to complete ReACT or CAMHS assessment tools on EPR
On rare occasions you may receive a pre-alert, where you want blood available for the patient when they arrive (for example in major haemorrhage). This process has been agreed with transfusion so this can be done safely and responsibly.
Delirium is one of a number of geriatric syndromes and has significant associated morbidity and mortality. 3 subtypes of delirium Hyperactive – easies to spot, one we are most familiar with. Characterised by agitation/aggression/hallucinations “the non cooperative patient” Hypoactive – harder to spot. Characterised by drowsiness, less responsive, vacant, sleeping more at home Mixed Remember …
Slides available – here Main topics of discussion were: Primary vs Secondary headache Red Flags Temporal Artritis Venous Sinus Thrombosis – its variable presentation, and need to highlight in the CT request.