Authors: Stephen Ojo / Editor: Steve Corry-Bass / Reviewer: Raghaventhar Manikandan / Codes: ELP3, MuP3, PC1, SLO1, SLO11, SLO2, SLO8 / Published: 19/07/2022
A 79-year-old man presented with a fall and sustained bruising to his face and pain in neck. He is on regular medications for previous stroke (no residual weakness), Atrial Fibrillation and Hypertension. He was examined and appropriate imaging was undertaken, this was all normal. His Blood tests were unremarkable. His Vital signs showed a mild Tachycardia (Pulse of 92), EWS 1. A secondary survey showed no additional injuries.
He lives by himself and was admitted to Clinical Decisions Unit (CDU) to allow his pain to settle and ensure adequate mobilisation prior to discharge. He was prescribed PRN analgesia only.
He developed chest pain while on the observations unit and his heart rate was found to be 165bpm irregular. ECG showed atrial fibrillation with fast ventricular response and Ischaemic changes (ST depression ). He was referred to cardiology and treated for NSTEMI.
Module Content
Ultrasound in Emergency Medicine - Level 1 Instruction
This document covers FAST, Assessment of the Abdominal Aorta and IVC, Vascular Access and Echocardiography in Life Support.
Stroke in the ED
Outlining the epidemiology and pathophysiology of stroke
Acute Dystonia
Acute dystonia is a movement disorder in which there is a state of abnormal tone produced by slow and sustained contractions of opposing muscle groups.
11 Comments
Not prescribing regular medicines is not uncommon in CDU setting . This case reinforced the fact about being mindful of prescribing regular meds.
Not prescribing regular medication for patients admitted to CDU is a frequent problem. I think it is joint responsibility between the admitting doctor, and the accepting nurse in CDU. I think a check list including drug chart, VTE prophylaxis, etc should be carried out before every admission to CDU.
simple & straight forward
short and sweet discussion!
Shame my ED doesn’t have a short stay unit attached – would be really useful.
Short and sweet
Effective module
Succinct.
very useful
patients should not be allowed to be admitted to CDU without a completed drug chart.
Unfortunately it is often not possible to have regular repeated senior reviews of patients on CDU, we should be honest about this.
Good case