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Adrenal crisis or insufficiency is a life threatening emergency due to the lack of glucocorticoid. Adrenal crisis can be primary due to destruction of the… Read more

Experience is showing that those with diabetic patients with COVID-19 are more likely to develop DKA/HSS. However, treating them with the traditional large amount of… Read more

Diabetic children sometimes attend ED with hyperglycaemia, but not in DKA (what should we do?) Paeds have produced some advice to follow: Ketones over 0.6?… Read more

Things to remember Give 0.9%NaCl Actrapid “Fixed Rate” 0.1unit/kg/hr Basal Insulin e.g. Levemir, Lantus, Semglee, Abasaglar, Toujeo, Tresiba, please continue this at usual dose and times… 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

90% of hypercalcaemia is due to either malignancy or hyperparathyroid. Severity: Adjusted Calcium (Ca) Severe: >3.5mmol/l – URGENT treatment (risk of dysrhythmia) Moderate: 3.0-3.5mmol/l  – PROMPT treatment (maybe well tolerated if… Read more

Hypernatraemia is a not a common presentation in ED, as intense thirst often prevents significant hypernatraemia in neurologically intact individuals. So… Mortality rates are high… 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

Hyponatraema is a common finding, especially within our elderly population. However, its significance is is not a simple numbers game, and needs senior input. Prior… Read more

Remove COLD, Add WARM, Don’t SHAKE 32-35ºC [Mild] – Shivering, Tachycardia, Tachypnoeic, Vasoconstriction 30-32ºC [Moderate] – Shivering stops, Pale/Cyanosed, Hypotensive, Confused, Lethargic <30ºC [Severe] –… Read more

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

REALISTIC EMERGENCY MEDICINE  Read more