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Protected: CRH Transfer Bag (Adult)
Protected: HRI Transfer Bag (Adult)
Posterior Shoulder Dislocation
Posterior shoulder dislocation is far less common than anterior dislocation. But it is commonly missed with some sources stating 50% of posterior dislocations are missed in the ED. Read more
Hyperkalaemia
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 & GP F/U)
- Moderate: 6.0-6.4mmol/l – Follow treatment guide (maybe suitable for discharge)
- Severe: ≥6.5mmol/l OR ECG changes – Follow treatment guide, must admit
Consenting for Blood Transfusion
We frequently consent for Blood Transfusion, but what risks do we tell the patients about and how common are those risks?
Necrotising Fasciitis
Necrotising fasciitis (NF) is a rare but serious bacterial infection that affects the soft tissue and fascia (Fournier gangrene, is NF affecting the perineum). In many cases NF progresses rapidly and early recognition and treatment is vital to halt progress. The mainstay of treatment is IV antibiotics and aggressive surgical debridement. Any delay increased the amount of tissue loss as well as the mortality. Read more
DVLA – Driving & Medical Conditions
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 DVLA, and we should encourage them to do so.
[There is a £1000 fine AND the risk of prosecution] Read more
Early Pregnancy Bleed <16/40
Bleeding in early pregnancy is a relatively common problem and in the many cases (esp. with spotting) the pregnancy remains viable. However, bleeding in early pregnancy should never be thought of as normal, and it is vital that we investigate this appropriately.
Communication is also vital at a very stressful time
- Who you are discussing this pregnancy in front of? – Does the patient want them to know
- Manage expectations – There is nothing we or mum can do to change the out come of the pregnancy apart from ensuring mum is well
- Ensure the patient has all the details they need – Return advice, clinic time, where to go, what is happening
- Be sensitive to the patients feelings – Patients respond very differently, be careful not to impose your emotions/assumptions on the situation
Think Anti-D!
Anti-D immunoglobulin guide
Search: ectopic pregnancy, Ectopic Pregancy, pv bleed, MISCARRIAGE, vaginal bleed, EPAU
Paediatric Hypoglycaemia
Paediatric Hypoglycaemia (BM <2.6) is a relatively common presentation in the Emergency Department. However, if we don’t do the BM it’s easy to miss.
Hypoglycaemia is generally caused by disruption in one of the following:
- Carbohydrate intake
- Carbohydrate absorption
- Gluconeogenesis
- Glycogenolysis