Polka Dots on a Tiny Tot

A 15-month-old presents to your ED with a rash and swelling on both legs and feet. The patient has a mild fever but is otherwise well.
Learning about lightning injuries
Investigating a child presenting with a limping gait to your Paediatric Emergency Department.
During Summer storms, lightning strikes can cause fatalities …but what happens to the survivors?
How will you manage a patient presenting with an atraumatic painful swelling of their great toe?
A pregnant female accidentally takes an excess of paracetamol. This SAQ explores the important considerations taken when managing acute paracetamol poisoning during pregnancy.
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.
Acute dystonia is a common presentation to the ED. Most cases occur as a result of recreational or prescribed drugs.
This month we have a brand new Co-host, Liz Farah. And the topics on discussion are Mortality in older patients boarding overnight in the ED, Hypertension in the ED and Cauda Equina Syndrome, Opioids for back pain & New Online
Another faller presents to your ED Confused and smelling of alcohol. What will you do? How can you avoid missing the common pitfalls?
A 57-year-old male patient presents with acute back pain and numbness in both legs.
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.
You are asked to see a 21-year-old student who cycled into a lamp post whilst intoxicated last night.
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 65-year-old female presents to the ED with a painful swollen left leg. How confident are you in risk assessment and management of DVT?
A 63-year-old male walks into the Emergency Department with elbow and forearm pain and initially appears well.
This month we look at a paper dealing with Performance of a prehospital HEART score in patients with possible myocardial infarction a prospective evaluation and also one on methocarbamol vs diazepam in management of acute lower back pain.
A 9-year-old girl attends the ED with a three day history of left wrist pain.
An 81-year-old woman attends ED from a Nursing Home with a reduced GCS, tachycardia, tachypnoea, hypotension, hypothermia and hyperglycaemia.
A 43-year-old lady presents with left thigh pain and swelling.
A 3-year-old girl presents to ED with a swollen left knee, limping.
This month we’ve got two New in EM segments: which shoulder relocation technique is best & the use of TXA in haemoptysis. We also speak with Tessa Davis of Don't Forget The Bubbles fame and her top tips for delivering teaching online. We then speak to Evan Bayton about the RCEM Coat of Arms and what on earth it all means, and then end the podcast with New Online.
You see a gentleman with a swollen knee. You decide he needs a Knee Aspiration.
Harry is a 2-year-old boy who presents to the ED with a one day history of a limp.
A child presents following a fall from monkey bars with a sore elbow.
A 30-year-old patient presents having fallen on an outstretched hand.
This month Noel and Stephen discuss diagnostic performance of S100B as a rule-out test for intracranial pathology in head-injured patients presenting to the ED who meet NICE Head Injury Guideline criteria for CT-head scan, and Graham discusses Paediatric acute non traumatic limp.
A 29-year-old male attends with left knee pain having been hit by a slow-moving car 2 days earlier.
A 56-year-old plumber attends with lower back pain and urinary incontinence.
A 6-year-old boy with a background of sickle cell disease presents to the ED with two days of worsening right hip pain and is unable to weight bear.
A young lady presented with abdominal pain, lethargy, (Groin) bone pain, depression and headache.
Another pain in the back SBA
A patient presents after falling backwards onto an outstretched right hand.
This month we have Neutrophil: lymphocyte ratio in septic arthritis, NICE SAH and New Online.
The unspoken disease of inflicted, non-accidental injury in children.
Learn the causes and management of a painful & swollen digit.
A hockey player attends having injured his ankle.
A 45-year-old man attends the ED 3 days after a motorbike accident.
A conducted energy device (CED) ‘taser’ was discharged into a patient’s shoulder. Before this patient is taken into police custody, you’ve been asked to assess them in your ED.
The Police have brought a patient to your ED that has had a controlled energy device discharged into their upper back. You are called to assess this patient.
Sudden onset of refusal to walk and leg pain in a well young child.
A 68-year-old man attends the ED one evening with a painful right knee.
Uncommon nerve entrapment syndromes are a group of conditions in which peripheral nerves are damaged through compression or repeated trauma.
Uncommon nerve entrapment syndromes are a group of conditions in which peripheral nerves are damaged through compression or repeated trauma.
A 72-year-old male presents to the ED with abdominal pain that has progressively worsened over the last 8 weeks.
Cervical spine immobilisation is the most commonly performed procedure in pre-hospital care
A 79-year-old male was admitted to the Clinical Decisions Unit (CDU) following a fall. Was he kept safe?
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 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.
A patient was pulled over from standing. He now has a painful swollen knee and is unable to weight-bear – what have they done and how can we help?
A minor injury with a major complication: applying clinically orientated anatomy in the ED.
The changing landscape of ultrasound - how do your images change, and how is it relevant?
A 12-year-old boy attends the ED with left knee pain and swelling while playing at school.
Elsie is a four year old who has come into the Emergency Department because her parents are concerned that she is not walking. Three days ago she was playing with her aunt and hurt her leg. Since then she has not been weight-bearing and her parents have been carrying her everywhere
A 29-year-old farmer presents to your local ED with a bite mark over the upper left calf.
A 40-year-old female presents with bilateral lower limb weakness and sensory loss
Cervical spine injuries are rare but potentially devastating. Immobilisation of the cervical spine on the slightest suspicion of injury is recommended by most resuscitation courses.
A young male presents to the Emergency Department with Non –Traumatic Limb Pain (NTLP) and a ‘hole’ was found on his X-ray.
A 7-year-old girl presents to the Paediatric A&E with a 3 week history of increasing pain in her right hip.
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. This month’s Top Papers comes from the beautiful hills of Snowdonia, with the team from Bangor Emergency Department bringing you this month’s summary of important articles for your attention.
Differential diagnosis of knee pain in the limping older child
A 20-year-old female who has fallen off her horse is complaining of right sided chest pain.
Referred pain into the upper extremities often accompanies neck pain. Referred pain can be the initial symptom of a compressed nerve root by a ruptured disc or stenosis at the foramina from osteophytes.
Welcome to the second of TERN’s Top Papers. Each month, a different region review a selection of papers on a different theme each month.
In UK ED practice a large group of patients present with musculo-skeletal disorders
This session covers the anatomy, common pathology and the clinical and radiological assessment of the shoulder and brachial plexus. This should lead to the formulation of appropriate management plans
Back pain is common: it is estimated that 60-80% of the population have back pain at some time during their life.
A 6-year-old boy attends the ED with a two week history of pain in the foot, which had developed into a limp over the preceding 2 days.
An 11-year-old boy presented to the Paediatric Emergency Department with a swelling to the lateral aspect of his left elbow.
A 74-year-male presented to the Emergency Department with neck pain. Whilst enjoying a round of golf, slipped backwards down a bank onto some rocks
This toddler has no medical history of note. He is the 3rd of 4 children under 6 years.
Radiology interpretation
Emergency department interventions for adult patients with low back pain: a systematic review of randomised controlled trials
A 67-year-old man, who had a background of diabetes, presents with pain on the left side of his neck, lower back pain and numbness in his left arm.
A 29-year-old female falls at home onto an outstretched arm
Noel discusses Colles type distal radial fractures undergoing manipulation in the ED A multicentre observational cohort study
FRCEM Primary Examination Single Best Answer
A 33-year-old female presents to the Emergency Department with atraumatic hip pain.
A 79-year-old woman presents with non-traumatic hip pain and fever.
A young male has concerning symptoms with a background history of G6PD deficiency…
A 56-year-old plumber presents to the ED with a 24-hour history of worsening lower back pain after lifting some heavy bags of cement.
We've all seen limping children. Maybe some of us have even had limping children. Some departments have excellent management strategies and pathways. Some don't. Here's some of our thoughts, musings and suggestions.
“Why can't I write anymore?”
What went wrong for a child who picked up Lymes’ instead of limes?
FRCEM Primary Examination Single Best Answer
A 7-year-old girl presents with an acute, painful hot knee and a red-purple non-blanching rash.
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
A case of acute bilateral ankle arthritis: septic joints? Or something else? How should you manage this in the ED?
4 year old child unable to weight bear, and inconsolable crying
FRCEM Primary Examination Single Best Answer
Research in Emergency Medicine ranges in scale and complexity and covers a wide spectrum of subjects, all of which contribute to our overall knowledge base
FRCEM Primary Examination Single Best Answer
10 X-rays in an SAQ and 5 MCQ's to test your knowledge of fractures of the midfoot and forefoot
November 2018
With the advent of urgent care centres, your exposure to orthopaedics won’t be what it used to be. However, if you follow some of the basic tips here, your orthopaedic surgeons and patients will be happy!
January 2018
Acute back pain is something that we see fairly often in the emergency department
March 2017 New in EM
Critical Appraisal: Appraising a Diagnostic Test: D-Dimer
Procedural sedation is an amazingly useful skill to have, but it is not without its perils. Listen to our podcast for some tips on how to get started or to improve your practi
This is the third in a series of Emergency Casebooks from the virtual hospital CFN General, with key learning points for staff working in an Emergency Department
Commonly, not much is known about transient synovitis (TS), and for many ED clinicians, it is a diagnosis of exclusion, as when a patient presenting with hip pain