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Some patients present to ED with symptoms or investigations suspicious an undiagnosed cancer, but don’t require emergency admission. To reduce the barriers to care the… Read more

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

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

Diabetic Ketoacidosis – remember in paediatrics this may be the 1st presentation of diabetes. Fluid – are more considered that adults due to the risk… 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

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 &… 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

Hypocalcaemia can life threatening, due to arrhythmias and seizures. Severity – Adjusted Calcium (Ca) Mild: >1.9mmol/l Severe: ≤1.9mmol/l OR Symptomatic 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

Classification Normal: 1.1-0.7 Mild: 0.69-0.5 Moderate: 0.49-0.4 Severe: <0.4 Signs/Symps (normally <0.5) MSK: Muscle Twitch, Tremor, Tetany, Cramps CNS: Apathy, Depression, Hallucination, Agitation, Confusion, Seizure… 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

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… Read more

When patients sent in by GP “” – how much do you do? Pseudo-Hyperkalaemia Pathway * Examples of High Risk Patients: Dialysis, Renal Transplant, CKD… Read more

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… Read more