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

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.
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.
A 3-year-old child presents to your emergency department with a rash, fever and vomiting.
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.
You are about to see two patients both of whom have testicular pain
This month we have Ketamine and Ondansetron, Hyperemesis Gravidarum, an interview with Vicky Price (SAM), Antibiotics for brain injury and New Online
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.
This module covers the assessment and management of patients presenting with breathlessness to the ED.
Early recognition and treatment of sepsis in children is crucial as progression to organ failure and shock is often very rapid.
A 36-year-old male presents with a 5-day history of sore throat, fever and dehydration.
The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity.
The child with decreased consciousness is a common problem with many possible diagnoses and potentially high mortality and morbidity
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.
A 27-year-old man is brought to the ED by ambulance after having two seizures. He has no known health problems.
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.
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.
Pre-alert; Adult male with long term front of neck access is en route in acute respiratory distress, what are your next steps?
A 5-year-old boy presents with a central boggy swelling to his forehead without history of trauma, what’s the differential?
Diagnosis and management of itchy bedbug bites!
A 26-year-old Indian man presents to the ED after being unwell for 5 days complaining of weakness, fever and headache.
A 10-day-old male infant presents with redness and discharge from both eyes.
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.
A large fluid filled mass
A 25-year-old man has attended the Emergency Department four times in the last fortnight with low back pain.
A previously healthy patient presents with a rapid onset illness, with fever, rash and tachycardia - what could be the culprit?
A 63-year-old male walks into the Emergency Department with elbow and forearm pain and initially appears well.
Everyone’s talking about sepsis lately, but do you know what to do?
Wounds abound in your ED, but who needs ‘a tetanus’?
Lyme disease is a spirochete infection transmitted by ticks. ED presentation, although rare, is important to identify to enable early treatment
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.
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.
Describing the initial management of tetanus in the ED.
Describing the initial management of tetanus in the ED.
A 28-year-old man recently returned from abroad. He is feverish with sore eyes and a rash.
Doctor, why is my vision worse after surgery?
This month we have Liberal vs. restrictive fluids in sepsis, Management and investigation of results from the ED, GreenED and New Online.
A 40-year-old female presents to the Emergency Department feeling lethargic for 24 hours.
A 3-year-old boy presents with a 6-day history of vomiting and “stillness”.
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.
Your department is crowded with multiple ambulances arriving, very few empty clinical spaces and multiple boarded patients due to exit block.
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?
A 31-year-old man attends the ED two days after returning from a holiday in the Gambia.
A man with weight loss, abdominal pain and fevers attends your ED. He has HIV and is on antiretroviral therapy.
Severe complications of chickenpox that can lead to hospitalisation.
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?
Management of Cardiac Transplant Patients in the ED.
Management of Cardiac Transplant Patients in the ED.
This module focuses on community acquired pneumonia (CAP) which is by far the commonest form of pneumonia seen in the Emergency Department.
This session covers community-acquired pneumonia (CAP), which is by far the commonest form of pneumonia seen 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.
A woman presents with breast pain and fever to your emergency department. How will you manage this patient?
This module is a summary on notifiable diseases aiming to put the notification process in context of the wider public health implications.
This module is a summary on notifiable diseases aiming to put the notification process in context of the wider public health implications.
Refresh your knowledge on this latest outbreak.
A 4-year-old boy presents to the ED due to a 5 day history of general malaise, pyrexia, coughing and a rash.
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.
A recently returned traveller attends your ED with viraemic symptoms and pyrexia, what could the culprit be?
A lady presents with decompensated liver disease and the CT reveals more than just ascites and cirrhosis.
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.
A 72-year-old male presents to the ED with abdominal pain that has progressively worsened over the last 8 weeks.
This session outlines a standardised approach to providing care for a haemodynamically normal patient presenting following rape or sexual assault.
This session outlines a standardised approach to providing care for a haemodynamically normal patient presenting following rape or sexual assault.
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?
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.
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. 
Management of Heat Stroke in the ED
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.
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
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.
There’s a lot to know about PEM. Can you answer our questions on some of the more common PEM?
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.
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.
A 6-month-old boy brought in because he can’t breathe.
This month we discuss Comparison of Q SOFA and hospital early warning scores for prognosis in suspected sepsis in ED patients: A systematic review.
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.
An SAQ designed to consolidate your knowledge on the features and management of Kawasaki disease.
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.
Recognising the clinical features of invasive meningococcal disease in children
Recognising the clinical features of invasive meningococcal disease in children
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 36-year-old male presents in respiratory distress.
A 19-year-old student attends the ED (accompanied by a friend) and, at triage, complains of abdominal pain.
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
This month we discuss the Usability of EHRs
This session describes the most common childhood exanthems that present to emergency departments
34-year-old male with malaise, myalgia, bilateral neck swelling and a headache
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.
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?
An 11-month-old boy presents after developing rashes on his hands, feet, and around his mouth.
Impetigo, erysipelas, cellulitis and necrotising fasciitis represent a spectrum of soft tissue infections
This session covers the cause, clinical features, treatment and management of impetigo, cellulitis, erysipelas and necrotising fasciitis
FRCEM Primary Examination Single Best Answer
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.
Needlestick injuries occur in healthcare workers and members of the public. Although transmission of blood borne viruses is unlikely, they cause considerable concern.
A 33-year-old female presents to the Emergency Department with atraumatic hip pain.
Understanding paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS)
Understanding paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS).
This month we discuss prognostic accuracy of q-sofa , lactate criteria for mortality in adults
This month we have New in EM Blood cultures, Dental Emergencies, RCEM FIB Guidelines
This month Noel talks to Dr.Anju menon about glucose as an additional parameter in NEWS score
A 79-year-old woman presents with non-traumatic hip pain and fever.
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.
CNS infections are relatively rare, but form a very important differential diagnosis in the unwell patient presenting to the ED.
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
Train hard, fight easy: Managing a cardiopulmonary arrest in a patient with suspected COVID-19
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?!
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.
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
RCEMLearning Coronavirus, COVID19, tips and resources
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?
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.
Describing the pathophysiology of cystic fibrosis
A 62-year-old woman presents with chest pain, fever, and systolic murmur.
Lyme disease is a spirochete infection transmitted by ticks. ED presentation, although rare, is important to identify to enable early treatment.
What went wrong for a child who picked up Lymes’ instead of limes?
FRCEM Primary Examination Single Best Answer
This month we discuss measles and Major incident triage
The first podcast in partnership with the EMJ
This month we have DVT guidelines | CRT vs Lactate Guided Fluid Resuscitation in Septic Shock | IAEM PoCUS 01 SHOC ED Study | DFTB18 Elliot Long | Stabbings in children | Non operative appendicitis management
March 2019 Podcast
Next to be seen is a 35 year old male, returned from Ghana, presenting with muscle pain, headaches, a history of fever and diarrhoea
TXA for haemoptysis, EMJ Podcast, Capacity, DFTB18 Domenic Cincotta, Premedication for ketamine sedation, C-spine in distracting injuries
November 2018
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?
January 2018
The new podcast for October 2017
March 2017 New in EM
It’s probably fair to say that few of us give any great thought on how a temperature is measured
Hello and welcome to the first of our daily podcast summaries from not-so-sunny Bournemouth for the RCEM annual scientific meeting
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
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
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!
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
Whenever I hear the word Ebola it brings a lump to my throat and a slightly sickening feeling in the pit of my stomach