Acute Coronary Syndrome

Last Updated on June 2, 2021 by frcemuserAcute Coronary Syndrome ST-segment-elevation myocardial infarction (STEMI) ST-segment elevation or new left bundle branch block (LBBB) present on ECG Non-ST-segment-elevation acute coronary syndromes Non-ST-segment-elevation myocardial infarction (NSTEMI) Other ECG changes (e.g. ST-segment depression, T-wave inversion) or normal ECG with troponin release present Unstable […]

Paracetamol Toxicity

Last Updated on May 29, 2021 by frcemuserOverview glutathione depletion leads to the builds up of toxic metabolite NAPQI and causes hepatic necrosis Initial assessment Calculate ingested dose in mg/kg to work out if significant ingestion: Disregard any additional kilos in excess of 110 kg If pregnant, enter pre-pregnancy, not […]

Delirium

Last Updated on May 29, 2021 by frcemuserTypes Precipitating factors for delirium The mnemonic SMASHED is a useful aide memoir when assessing the possible causes or precipitants of acute confusion: S Substrates: hyperglycaemia, hypoglycaemia, thiamine Sepsis M Meningitis and other CNS infections Mental Illness, functional psychoses A Alcohol intoxication or […]

Status Epilepticus – Adults

Last Updated on May 29, 2021 by frcemuserEmergency antiepileptic drug therapy Early status Administer IV 4 mg lorazepam (lorazepam 0.1 mg/kg IV) slowly into a large vein (diazepam 10 mg is an alternative) Repeat lorazepam 4 mg slowly after 10 minutes if seizures continue If there is no venous access, […]

Allergy

Last Updated on May 28, 2021 by frcemuserAllergic Reaction IgE mediated mast cell degranulation and histamine release as in urticaria Type I hypersensitivity Urticaria Treatment In ED: identify the cause and trigger – avoidable cause and trigger Non-sedating antihistamine – Cetrizine , loratadine, fexofanadine if severe add steroids oral – […]

Foreign Body Throat

Last Updated on March 21, 2021 by frcemuserThe most common foreign body to get stuck in the throat is a fishbone in the piriform fossa (sinus) or the valleculae on either side of the median glossoepiglottic fold. Direct visualisation with a good light and tongue depressor/laryngoscope may reveal the foreign […]

Otitis externa

Last Updated on March 21, 2021 by frcemuserOtitis externa is inflammation of the external ear canal. It may be localised (where there is an infected hair follicle, potentially progressing to a boil in the ear canal) or generalised where there is more widespread inflammation of the skin and subdermis. It […]

Vertigo – Ear Problem

Last Updated on March 21, 2021 by frcemuser Diagnosis Benign paroxysmal positional vertigo (BPPV) Vestibular neuritis Labyrinthitis Meniere‚Äôs disease Epidemiology Can affect people of any age but commonly presents around 50 years. F > M. Affects previously well young or middle-aged adults. Affects previously well young or middle-aged adults. Occurs […]

Acute otitis media

Last Updated on March 21, 2021 by frcemuserAcute otitis media (AOM) is defined as the presence of inflammation in the middle ear, associated with effusion and accompanied by the rapid onset of symptoms and signs of an ear infection. AOM may be caused by viral or bacterial infection. The most […]

Perforated tympanic membrane

Last Updated on March 21, 2021 by frcemuserIn perforated tympanic membrane, the patient may experience pain, reduced hearing and sometimes a bloody discharge. Causes: Infections of the middle ear (otitis media) Direct injury to the ear e.g. punch injury, poking objects into the ear A sudden loud noise e.g. from […]