Author: embeds

02-Feb-2024

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.

29-Jan-2024

Snake Bites

In the UK approximately 100 people are envenomated by a snake each year.

So what do you need to do if your patient has received a venomous bite from a snake? (not the classic UK cocktail).

Don’t Cut & Suck!
Treat what you see
Call Toxbase

23-Jan-2024

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

21-Jan-2024

Bilary Disease

Gallstones are common, with a prevalence of approximately 10–15% of adults in Europe and the U.S. Most of the time patients are asymptomatic. but there are several ways gallstone disease can present.

15-Jan-2024

Meningitis – Adults

Keep your suspicions high – early signs it may not be clear
Sepsis Kills – give antibiotics & fluid early
Consider Acyclovir
Give Dexamethasone with Antibiotics – it can reduce neurological sequelae
Consider indications for CT before LP
Get SENIOR support early

15-Jan-2024

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

15-Jan-2024

Rape & Sexual Assault

Don’t

Preform intimate examinations on Sexual assault/Rape patients

Unless life-threatening injuries are suspected e.g Haemorrhage.
As our examination will inevitably destroy evidence that may aid this patient’s case

Do’s

Consider contamination injury (HIV, HepB, HepC) – Guide
Consider emergency contraception
Children must have police referral for safeguarding and discussion with social care. The paediatricians in CHT may be able to offer support in navigation of services but the responsibility for non-urgent medical assessment lies with specialists at SARC.
Refer to The Sexual Assault Referral Centre, either via Police or Self referral

13-Jan-2024

Hypocalcaemia

Hypocalcaemia can life threatening, due to arrhythmias and seizures.

Severity – Adjusted Calcium (Ca)

Mild: >1.9mmol/l
Severe: ≤1.9mmol/l OR Symptomatic

06-Jan-2024

Chest Trauma – WYMTN

Chest injury as part of major trauma, can range from painful to life threatening so prompt treatment and recognition is vital. Esp. in ‘Silver Trauma’ when ‘minor’ injuries may have devastating consequences – the full guidance can be found @WYMTN – HERE

30-Dec-2023

Diverticulosis, diverticular disease and diverticulitis

The prevalence of diverticula Is unknown as most are asymptomatic. However, it is rare before the age of 40 and increases with age.

Diverticulosis occurs in 5–10% of people aged 45 years and older.
Diverticulosis occurs in about 80% of people aged 85 years and older.

For people with diverticulosis, the lifetime risk of developing acute diverticulitis is about 4–25%