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A 73-year-old female, who lives alone, is found collapsed at home by her neighbours and brought in the ED.
An elderly lady presents to the emergency department from a nursing home having been found on the floor in her room
Hyperglycaemic hyperosmolar state is a medical emergency and is different from DKA and as such its treatment requires a different approach.
A 4-year-old presents with hypoglycaemia and all you can think of is a slushy?
You diagnose DKA in a child, how much fluids do you prescribe?
This month we discuss the PERC 35 Rule | Glucocorticoid-induced adrenal insufficiency | and New Online content
A 51-year-old man presents with acute onset of central chest pain accompanied by nausea, vomiting and paralysis of all four limbs.
Best practice advice on how Emergency Departments should implement screening programmes and balance these with the need to assess and treat acute illness and injury.
How to recognise and manage patients with Acute Behavioural Disturbance in order to support their emergency care whilst maintaining safety of the patient, staff, and others.
A 45-year-old male with a history of hypertension, type 2 diabetes mellitus, and Von Hippel-Lindau syndrome presents to the ED with paroxysmal headaches and elevated blood pressure.
This session identifies the clinical features of acute behavioural disturbance (ABD) and covers the initial assessment and management of patients with ABD in the ED.
The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity.
A few key points that, we think, will make the management of DKA clearer.
Diabetic Ketoacidosis, very common presentation to the ED, is a potentially life-threatening complication of type 1 diabetes. The Joint British Diabetes Societies have developed recent consensus guidelines to guide management.
A 30-year-old female attended the Emergency Department after vomiting, feeling weak and ‘not quite with it’.
An elderly lady presenting with vague symptoms is found to have a deranged blood gas.
This month we discuss the SQUID protocol for DKA, Concussion Guidelines, The Physiologically Difficult Airway and New Online.
A 38-year-old fit and well female, who is 29 weeks pregnant, attends with a sudden onset of worsening, retro-orbital headache.
A 12-month-old diabetic girl presents generally unwell and vomiting.
A 76-year-old diabetic is referred with confusion and is being treated for a UTI. She is tachycardic and drowsy, is there more than sepsis?
An 81-year-old woman attends ED from a Nursing Home with a reduced GCS, tachycardia, tachypnoea, hypotension, hypothermia and hyperglycaemia.
A 46-year-old gentleman with a known history of alcohol dependence re-attends to the ED with a reduced GCS. Is he just drunk?
Nikki Abela and Liz Herrieven have treated themselves to the RCEM PEM Conference in Manchester on 21/3/2023 – World Down Syndrome Day. Put on your #LotsOfSocks for the day and have a read to see what they learned.
A 67-year-old lady presents to the ED with mild wheeze, frontal headache, fever and vomiting. She is hypotensive and tachycardic. You arrange to see her in Resus.
A 77-year-old gentleman presents to the ED five days after his endoscopic endonasal transsphenoid resection of his pituitary adenoma with a severe frontal headache, fever and multiple episodes of vomiting.
A 71-year-old female with recurrent dizzy episodes over the past 2 years.
A woman presents with 10/10 eye pain. Consider what could be going on, rule out the red flags and address her urgent concerns!
Hyperosmolar hyperglycaemic State is a common presentation to the ED which can mimic many other disease processes.
Hyperosmolar hyperglycaemic State is a common presentation to the ED which can mimic many other disease processes.
A 63-year-old female with a background of type I diabetes mellitus, chronic pancreatitis and COPD presents to the ED with confusion and hypoglycaemia.
A woman with diplopia needs your help. Can you identify the cause and include or exclude any red flags?
A lady presents with decompensated liver disease and the CT reveals more than just ascites and cirrhosis.
A 20-year old female presents to the ED with reduced GCS and profuse vomiting following a night out.
Addison's disease otherwise known as primary adrenal insufficiency or hypoadrenalism is a relatively rare disorder. It can affect people of any age, although it mostly occurs in women and in those between the ages of 30-50.
A 45-year-old gentleman with a history of uncontrolled Diabetes and Hypertension comes into the ED with pain and numbness of his left thigh.
A 27-year-old single Caucasian male attends the ED after an episode of paralysis of his limbs at home.
We’ve all seen diabetic foot presentations in the ED but many more of them are managed successfully in primary care and podiatry clinics. As in many other areas, the ED has a huge role to play in prevention as well as treatment.
Thyroid storm is a rare but life-threatening endocrine condition that should be considered, recognised and treated quickly
An anxious 45-year-old male presents to your Emergency Department with acute neck swelling.
This month Suzie and Raj discuss the experience of Emergency Department patients after a visit for Hypoglycaemia
The neonatal period (<28 days of age) and young infancy (< 3months ) is the most common time for presentation of congenital conditions and the highest susceptibility for infection.
The spontaneous presentation of phaeochromocytoma is normally between the age of 40 and 50 years, however the hereditary forms often present in younger individuals, including children.
Describing the key features relevant to the history of phaeochromocytoma
A 43-year-old man is hypotensive, tachycardic and febrile… barn door sepsis or something else? The devil is in the detail!
For hypercalcaemia to develop, the normal calcium regulation system must be overwhelmed by an excess of PTH, calcitriol, some other serum factor that can mimic these hormones, or a huge calcium load.
This session will describe calcium homeostasis. It will also examine therapeutic uses of calcium and discuss the disturbances of hypercalcaemia and hypocalcaemia.
This session will explore the management of diabetic ketoacidosis in young people with relevance to the published evidence and national guidelines.
This session describes the most common childhood exanthems that present to emergency departments
Hypoglycaemia is usually unpleasant, often becomes a source of fear, and can be an embarrassment as well as a safety risk
Hypoglycaemia is easily diagnosed and treated in emergency departments (EDs), if it is considered. In this session we will look at the presentation, causes and treatment options available.
A 32-year-old type 1 diabetic female presents at 30/40 gestation of her first pregnancy feeling generally unwell.
This module will focus on secondary causes of acute severe headaches that are likely to present to an emergency department.
This month we discuss Undoing Skin Glue Mishaps | PoCUS for skin abscess | AAA | Paeds DKA
A young male attends with fever and other symptoms. He also has weakness of his lower limbs is unexpected in rela-tion to his other presenting complaints.
A few key points that, we think, will make the management of DKA clearer.
In this blog we're talking about hyperglycaemia in the ED. There aren't any official guidelines on management, but our experience has shown that there's a huge variation in practice, and many cases are mismanaged.
Thyroid storm is a rare but life-threatening endocrine condition that should be considered, recognised and treated quickly
This session will explore the management of diabetic ketoacidosis in young people with relevance to the published evidence and national guidelines
This blog is an overview of how to approach an unwell infant. It covers diagnoses not to be missed, how to spot them and a few tips about management.