Infectious Diseases - RCEMLearning

Blog

Frailty Associated Pneumonia

Is it time to ditch ‘Aspiration Pneumonia’ and replace it with ‘Frailty Associated Pneumonia’?

Clinical Case

Aggression in Patient with Learning Disability

A patient with moderate learning disability is brought in by their father because he has suddenly become aggressive.

Mpox (monkeypox) Outbreak

Refresh your knowledge on this latest outbreak.

Guideline

Screening in the Emergency Department – Guideline

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.

Podcast

August 2024

This month we have HFNC vs NIV COPD, RCEM and NPIS Opioid Toxicity Guidelines, Gestalt for predicting sepsis and New Online

EM Quiz

Curriculum Quiz: Infectious Diseases

30 questions. 30 minutes. Test yourself against your colleagues!

Clinical Case

A stag do abroad

34-year-old male with malaise, myalgia, bilateral neck swelling and a headache

Guideline

Management of Acute Presentations of Sickle Cell Disease in the Emergency Department – Guideline

How to manage acute sickle cell disease. Focus on early analgesia, warmth, hydration, and oxygenation. Recognition and management of specific complications. Criteria for admission and discharge.

Clinical Case

To drain or not to drain?

A 67-year-old man presents with shortness of breath and fever. He has recently completed his first 2 week chemotherapy course for auricular Squamous Cell Carcinoma, administered via a PICC line.

Persistent Fever with Rash in Children

A 3-year-old child presents to your emergency department with a rash, fever and vomiting.

Blog

A child with a fever

Febrile children compete for the most common non-traumatic paediatric presentation in the ED, causing concern for parents worldwide. Your mission: to find the source.

A Teste-ing ED Shift

You are about to see two patients both of whom have testicular pain

Podcast

April 2024

This month we have Ketamine and Ondansetron, Hyperemesis Gravidarum, an interview with Vicky Price (SAM), Antibiotics for brain injury and New Online

Reference

Breathlessness

Dyspnoea is an overall term used to describe an unpleasant awareness of increased respiratory effort and will be used synonymously with "breathlessness" in this session.

Learning Session

Breathlessness

This module covers the assessment and management of patients presenting with breathlessness to the ED.

Blog

Recognising Paediatric Sepsis

Early recognition and treatment of sepsis in children is crucial as progression to organ failure and shock is often very rapid.

Throat Pain

A 36-year-old male presents with a 5-day history of sore throat, fever and dehydration.

Reference

Decreased Conscious Level in a Child

The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity.

Learning Session

Decreased Conscious Level in a Child

The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity

Clinical Case

It’s all in her head

A 10-year-old girl presents with lethargy, vomiting, headaches and an unsteady gait. She collapsed at home a few hours prior to arrival at your ED.

Clinical Case

Not Very Common in the UK

A 27-year-old man is brought to the ED by ambulance after having two seizures. He has no known health problems.

Clinical Case

Bloody Cough

A 22-year-old South Asian male presents with 2 episodes of haemoptysis on a background of anorexia, weight loss and a dry cough for 2 months.

Blog

Many of us in the UK EM will have gone most of our careers without seeing any confirmed cases of measles. Vaccination rates have been dropping though, so measles is back in our departments and has to be in our differential diagnosis list.

Everyday I’m Suctioning, Tracheostomy Emergency

Pre-alert; Adult male with long term front of neck access is en route in acute respiratory distress, what are your next steps?

Clinical Case

NAI or not

A 5-year-old boy presents with a central boggy swelling to his forehead without history of trauma, what’s the differential?

Sleep tight and don’t let the bed bugs bite

Diagnosis and management of itchy bedbug bites!

Fever in Fiji

A 26-year-old Indian man presents to the ED after being unwell for 5 days complaining of weakness, fever and headache.

Clinical Case

Neonatal Conjunctivitis

A 10-day-old male infant presents with redness and discharge from both eyes.

Clinical Case

Painful Big Toe

An 81-year-old gentleman presents to the ED with a 3 week history of worsening pain and erythema of his great toe despite antibiotics.

Clinical Case

A Sceptical Septic Psoas

A large fluid filled mass

Clinical Case

Back pain in a young person

A 25-year-old man has attended the Emergency Department four times in the last fortnight with low back pain.

Clinical Case

Feeling Hot, Hot, Hot

A previously healthy patient presents with a rapid onset illness, with fever, rash and tachycardia - what could be the culprit?

Clinical Case

Severe arm pain after a superficial burn

A 63-year-old male walks into the Emergency Department with elbow and forearm pain and initially appears well.

Making Sepsis Sixy

Everyone’s talking about sepsis lately, but do you know what to do?

Tetanus in the ED

Wounds abound in your ED, but who needs ‘a tetanus’?

Learning Session

Trek Tragedy!! Review on Lyme Disease

Lyme disease is a spirochete infection transmitted by ticks. ED presentation, although rare, is important to identify to enable early treatment

A Spot Diagnosis

A 50-year-old man attends the ED with a 2 day history of a rash on his hands. The rash is not itchy or painful and he is systemically well.

Blog

Skin Rashes Caused by Group A Streptococcus

Group A Streptococcus is responsible for many skin and soft tissue infections, which can be identified based on the appearance of the associated skin rashes.

Reference

Tetanus

Describing the initial management of tetanus in the ED.

Learning Session

Tetanus

Describing the initial management of tetanus in the ED.

Clinical Case

It’s gone viral!

A 28-year-old man recently returned from abroad. He is feverish with sore eyes and a rash.

The Red Eye

Doctor, why is my vision worse after surgery?

Podcast

March 2023

This month we have Liberal vs. restrictive fluids in sepsis, Management and investigation of results from the ED, GreenED and New Online.

Clinical Case

Maternal sepsis: be aware and beware!

A 40-year-old female presents to the Emergency Department feeling lethargic for 24 hours.

Clinical Case

Are you sure NEURO-kay?

A 3-year-old boy presents with a 6-day history of vomiting and “stillness”.

Clinical Case

Connect the Dots

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 Crowding Challenge

Your department is crowded with multiple ambulances arriving, very few empty clinical spaces and multiple boarded patients due to exit block.

Glandular Fever – It’s all in the kiss

Is love in the air? …or is it the kissing disease? It was only a kiss, how did it end up like this? A teenage boy got more than he was bargaining for after an innocent kiss with his girlfriend but do you know enough about the "kissing disease" to aid in his management?

Clinical Case

No Flies On You!

A 31-year-old man attends the ED two days after returning from a holiday in the Gambia.

Clinical Case

Complications of Chickenpox in Children

Severe complications of chickenpox that can lead to hospitalisation.

Blog

GAS, iGAS and Scarlet fever

Group A streptococcus/ Grp A Strep or GAS in short - What is it? Why is it happening? Why is it important now? Why the invasive increase in infection rate?

Reference

Management of Cardiac Transplant Patients in the Emergency Department

Management of Cardiac Transplant Patients in the ED.

Learning Session

Management of Cardiac Transplant Patients in the Emergency Department

Management of Cardiac Transplant Patients in the ED.

Reference

Community Acquired Pneumonia in Adults

This module focuses on community acquired pneumonia (CAP) which is by far the commonest form of pneumonia seen in the Emergency Department.

Learning Session

Community Acquired Pneumonia in Adults

This session covers community-acquired pneumonia (CAP), which is by far the commonest form of pneumonia seen in the ED.

Clinical Case

Delirium; a source of confusion in the ED

An elderly lady attends the ED unaccompanied in the middle of the night. She is very confused, agitated and becomes aggressive towards the staff.

Acute Breast Problem

A woman presents with breast pain and fever to your emergency department. How will you manage this patient?

Reference

Notifiable Diseases

This module is a summary on notifiable diseases aiming to put the notification process in context of the wider public health implications.

Learning Session

Notifiable Diseases

This module is a summary on notifiable diseases aiming to put the notification process in context of the wider public health implications.

Clinical Case

An Erythematous Eruption

A 4-year-old boy presents to the ED due to a 5 day history of general malaise, pyrexia, coughing and a rash.

Organ Donation & Changes in the Law

Preparing for exams and trying to find an SBA on organ donation? The law around organ donation has changed; refresh your knowledge with this SBA.

Clinical Case

The heart of the matter

A 62-year-old woman presents with chest pain, fever, and systolic murmur.

Clinical Case

A Malevolent Mosquito

A recently returned traveller attends your ED with viraemic symptoms and pyrexia, what could the culprit be?

Clinical Case

Decompensated liver failure not always just about the liver

A lady presents with decompensated liver disease and the CT reveals more than just ascites and cirrhosis.

Holiday Sore Throat: are Antibiotics required?

You take a history from a 16-year-old American boy and his parents who are on holiday in the UK for the next 2 weeks. He is complaining of a severe sore throat of 5 days duration.

Clinical Case

Let me see your back!

A 72-year-old male presents to the ED with abdominal pain that has progressively worsened over the last 8 weeks.

Learning Session

Sexual Assault Aftercare in the Emergency Department

This session outlines a standardised approach to providing care for a haemodynamically normal patient presenting following rape or sexual assault.

Reference

Sexual Assault Aftercare in the Emergency Department

This session outlines a standardised approach to providing care for a haemodynamically normal patient presenting following rape or sexual assault.

The Headache

A young man presents with fever, headache, photophobia and vomiting. Can you interpret the findings to diagnose and treat him appropriately before it’s too late?

Epistaxis in a child

A 7-year-old girl is brought into the ED by her mother on a busy Saturday afternoon after experiencing several nose bleeds at home over the preceding few hours.

TERN

TERN Top Papers July 2022

The aim of TERN Top Papers is to highlight the top emergency care related papers for emergency physicians, keeping them abreast of the latest practice-changing studies.

Heat Stroke – SAQ

Management of Heat Stroke in the ED

Clinical Case

A FACEnaTing Fever

A 72-year-old female presents to the ED with a four week history of worsening neck pain, lethargy, reduced sensation and difficulty with fine motor movements in her upper limbs.

Reference

Kawasaki Disease

This session aims to increase the awareness of Kawasaki disease with a focus on recognising the principal clinical features, in line with recent updates to the NICE guidelines

Learning Session

Kawasaki Disease

This learning session aims to increase the awareness of Kawasaki disease with a focus on recognising the principal clinical features, in line with recent updates to the NICE guidelines.

The Whole of PEM

There’s a lot to know about PEM. Can you answer our questions on some of the more common PEM?

Podcast

June 2022

In this months podcast, which happens to be Mark's last podcast as lead, we have Efficacy of antibiotics for septic olecrannon bursitis, Guidelines for EM, Anterior-Lateral vs Anterior-Posterior pad placement for cardioversion of AF, Case Based Discussions.

Baby Blues

A mother has rushed into the ED very concerned that her baby is blue. This case covers the importance of understanding cyanosis, with consideration for the potential causes and management in a 3 week old.

Just a viral infection

A 6-month-old boy brought in because he can’t breathe.

Podcast

EMJ Podcast May 2022

This month we discuss Comparison of Q SOFA and hospital early warning scores for prognosis in suspected sepsis in ED patients: A systematic review.

Lemons and Lymes

What went wrong for a child who picked up Lymes’ instead of limes?

TERN

February 2022 Virtual Journal Club – Fluid Response Evaluation in Sepsis Hypotension and Shock

At TERN Education we are keen to help you learn how to critically evaluate the evidence base behind your practice. In order to do this, we have been producing monthly virtual journal club (VJC) modules on RCEMLearning since March 2021.

Crash & Burn: Kawasaki disease

An SAQ designed to consolidate your knowledge on the features and management of Kawasaki disease.

TERN

TERN Top Papers February 2022

We are a team of EM doctors working in Wales. We have chosen to look at a range of paediatric papers, focusing on two sub-topics, attendances to the emergency department & paediatric infections.

Reference

Meningococcal Disease and Meningococcal Meningitis

Recognising the clinical features of invasive meningococcal disease in children

Learning Session

Meningococcal Disease and Meningococcal Meningitis

Recognising the clinical features of invasive meningococcal disease in children

PEM Induction

A child with a fever – PEM Induction

Febrile children compete for the most common non-traumatic paediatric presentation in the ED, causing concern for parents worldwide. Your mission: to find the source.

More tests for shortness of breath

A 36-year-old male presents in respiratory distress.

Clinical Case

Sexual assault victims in the ED

A 19-year-old student attends the ED (accompanied by a friend) and, at triage, complains of abdominal pain.

Reference

Urinary Tract Infections in Children

This session looks at the techniques available to collect urine samples from children in an emergency department. It discusses the evidence basis and the relative merits of each technique

Podcast

EMJ Podcast June 2021

This month we discuss the Usability of EHRs

Learning Session

Common Childhood Exanthems

This session describes the most common childhood exanthems that present to emergency departments

Reference

Coma

This session covers effective assessment, diagnosis and management of the patients presenting with coma.

Seriously, Not Another Protocol? (EBM)

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.

‘Coronitis Pigmentosa’ – A blind diagnosis?

You receive a sepsis pre-alert for a 39 year old female who is brought in by ambulance vomiting. She has muscle aches and a fever for 5 days. She is triaged to Covid resus. Her blood gas isn’t pretty. What are we missing?

Clinical Case

Living A Rash Hand-To-Mouth Existence

An 11-month-old boy presents after developing rashes on his hands, feet, and around his mouth.

Reference

Cellulitis and Other Skin Infections

Impetigo, erysipelas, cellulitis and necrotising fasciitis represent a spectrum of soft tissue infections

Learning Session

Cellulitis and Other Skin Infections

This session covers the cause, clinical features, treatment and management of impetigo, cellulitis, erysipelas and necrotising fasciitis

FRCEM

FRCEM Primary Paper 1

FRCEM Primary Examination Single Best Answer

Reference

Needlestick Injury

Needlestick injury is a wound piercing the skin caused by a contaminated sharps instrument, most commonly a hypodermic needle. This session considers needlestick injuries in both healthcare workers (HCW) and members of the public.

Learning Session

Needlestick Injury

Needlestick injuries occur in healthcare workers and members of the public. Although transmission of blood borne viruses is unlikely, they cause considerable concern.

Clinical Case

It’s Never Lupus

A 33-year-old female presents to the Emergency Department with atraumatic hip pain.

Time for PIMS-TS

Understanding paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS)

Paediatric Inflammatory Multisystem Syndrome (PIMS-TS)

Understanding paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS).

Podcast

EMJ July 2020

This month we discuss prognostic accuracy of q-sofa , lactate criteria for mortality in adults

Podcast

July 2020

This month we have New in EM Blood cultures, Dental Emergencies, RCEM FIB Guidelines

Podcast

EMJ June 2020

This month Noel talks to Dr.Anju menon about glucose as an additional parameter in NEWS score

Clinical Case

Can’t Bear To Weightbear

A 79-year-old woman presents with non-traumatic hip pain and fever.

Coronavirus

A 38-year-old male presents with a continuous cough, shortness of breath and fevers. Over the past 2 days he has had intense generalised muscle aches, fatigue, loss of taste and smell and a reduced appetite.

Reference

Intracranial Infections

CNS infections are relatively rare, but form a very important differential diagnosis in the unwell patient presenting to the ED.

Learning Session

Intracranial Infections

Intracranial infections (also called central nervous system infections or CNS infections) are relatively rare, but form a very important differential diagnosis in the unwell patient

The COVID-19 Arrest

Train hard, fight easy: Managing a cardiopulmonary arrest in a patient with suspected COVID-19

Blog

Ear Disease

To the ENT novice there are a baffling number of terms that refer to problems with the ear... "otitis media" is that acute? Or suppurative? Or secretory? And where does glue ear fit into all of this and what are grommets anyway?!

The Waves of COVID-19

Exploring the role of lung ultrasound in patients with COVID-19 in the Emergency Department.

The Coronavirus Cough

A 58-year-old primary school teacher with type 2 diabetes mellitus presents to your ED with shortness of breath. His breathlessness has increased overnight and is exacerbated on minimal exertion.

iBook

COVID-19 iBook

All our Current COVID-19 information collated together in one handy iBook alongside amazing content from St Emlyn's and Don't forget the bubbles

Popping Out

It's a busy Friday night in the emergency department and another facial injury presents following an alleged assault to the right eye.

Blog

Coronavirus, (COVID19) tips and resources

RCEMLearning Coronavirus, COVID19, tips and resources

Fishing for a diagnosis

A keen fisherman attends following a flu-like illness. He has a small head wound and is now jaundiced. One sign brings it all together, can you spot it?

Reference

Adult Cystic Fibrosis

Cystic Fibrosis is caused by a mutation in a gene that encodes cystic fibrosis transmembrane conductance regulator (CFTR) protein, which is expressed in many epithelial and blood cells.

Learning Session

Adult Cystic Fibrosis

Describing the pathophysiology of cystic fibrosis

Reference

Trek Tragedy!! Review on Lyme Disease

Lyme disease is a spirochete infection transmitted by ticks. ED presentation, although rare, is important to identify to enable early treatment.

FRCEM

FRCEM Primary Paper 5

FRCEM Primary Examination Single Best Answer

Podcast

EMJ Podcast May 2019

This month we discuss measles and Major incident triage

Podcast

EMJ Podcast April 2019

The first podcast in partnership with the EMJ

Podcast

April 2019

Podcast

March 2019

March 2019 Podcast

Blog

Tropical Diseases

Next to be seen is a 35 year old male, returned from Ghana, presenting with muscle pain, headaches, a history of fever and diarrhoea

Podcast

February 2019

TXA for haemoptysis, EMJ Podcast, Capacity, DFTB18 Domenic Cincotta, Premedication for ketamine sedation, C-spine in distracting injuries

Podcast

November 2018

Blog

Meningitis

You pick up the next patient to be seen. It's a 25 year old who has neck stiffness, and a headache, and a sore throat. The GP has sent them in as a possible meningitis patient. Where do you go from there?

Podcast

January 2018

Podcast

October 2017

The new podcast for October 2017

Podcast

March 2017

March 2017 New in EM

Blog

Temp Taking and How to Take It

It’s probably fair to say that few of us give any great thought on how a temperature is measured

Podcast

Day 1– RCEM Bournemouth #RCEM16Beach

Hello and welcome to the first of our daily podcast summaries from not-so-sunny Bournemouth for the RCEM annual scientific meeting

Podcast

Sepsis Guidelines

There has been a lot of talk about sepsis over the last year, in fact I heard someone recently saying they had “sepsis” fatigue, there have been so many debates in the FOAMed world this year

Podcast

RCEM Leeds day 1

Welcome to the RCEM CPD event in Leeds. We're here to give you updates and some pearls that we've gleaned from the conference

Podcast

RCEM Manchester Day 1

So RCEM '15 in Manchester has been a sell out! So for those of you that weren't lucky enough to be here, here's what's been going on on Day 1!

Podcast

Are you taking the pee? Urine testing in the ED

Urine testing potentially isn’t the most glamorous of topics but it’s an area which there’s a HUGE scope for us improving on

Blog

Ebola & what next?

Whenever I hear the word Ebola it brings a lump to my throat and a slightly sickening feeling in the pit of my stomach

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