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Confidentiality, Capacity and Consent in PEM

It’s Friday evening and you’re at work in the ED (where else would you rather be??). Jack is a 15-year-old boy who has taken an overdose of paracetamol a couple of hours ago. He texted his girlfriend soon after and she called an ambulance.

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Accidental drug overdose

You receive a standby call for red-flag sepsis – Initial pattern recognition triggers the pathway. Shortly after arriving you experience ‘pattern interrupt’ and ponder new evidence in the treatment of this condition.

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Toxicology – Induction

You’ve just arrived for your first ED shift, excited to be allocated to resus. The red phone rings. A 45-year-old female, amitriptyline overdose, P120, BP85/45, GCS 5, ETA 5 minutes.

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Carbamazepine – A Toxic Shock

A 46-year-old man is brought by ambulance to the ED. He has been drinking alcohol all afternoon and, according to collateral from his wife, he has taken ‘some tablets’ two hours prior the presentation.

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Ecstasy

Class A drug in the UK – illegal to possess, give away or sell. Possession can be punished with 7 years in jail.

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Spill the Tea

A 32-year-old man presents to the ED with RUQ, tachycardia and diarrhoea after starting a new herbal supplement for weight loss.

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Toxicology

You’ve just arrived for your first ED shift, excited to be allocated to resus. The red phone rings. A 45-year-old female, amitriptyline overdose, P120, BP85/45, GCS 5, ETA 5 minutes.

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