A 27-year-old female presents to the ED with one day history of sudden onset of moderate to severe intensity headache, vomiting, diplopia and abdominal discomfort.
Sudden onset of neurological symptoms after exertion, accompanied by vacant episodes that were triggered by movement of the arm due to steno occlusive disease in the subclavian artery, proximal to the origin of the ipsilateral vertebral artery.
A 45-year-old woman presents to the ED with a history of headache persisting for the past 4-5 days, accompanied by an inability to open her left eye for the past day.
SBA session on the RCEM recommendations about the management of an aggressive patient with acute behavioural disturbance (ABD). How to keep your patient, your colleagues, and yourself safe!
Low back pain is a very common problem and it is estimated that 80% of the population suffer from it at some stage of their life. It is also a common presentation to emergency departments.
This month we have: Surgery for Haemorrhagic Stroke | RCEM Best Practice Guidelines for Acute Pain | Laura Howard and Gregory Yates - BestBETs | New Online
A 29-year-old male is working a shift behind the bar and complains of feeling dizzy. He collapses and makes a quick recovery. This is not the first time.
This month we have: Blood biomarkers and algorithms and fever duration in febrile infants, Guidelines for EM - Sickle Cell Disease (Part Two), Absorbable vs non-absorbable sutures in facial lacerations and New Online.
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.
Headaches are one of the most common presentations to the ED and may be primary or secondary. We want to help you differentiate between those benign ones that just require simple analgesia and reassurance, and those that require further investigation.
This module identifies the clinical features of acute behavioural disturbance (ABD) and covers the initial assessment and management of patients with ABD in the Emergency Department.
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.
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.
You take handover for a patient in resus. They have presented with new onset of focal seizures. You start treatment but the convulsions are worsening. What will you do?
This month we discuss: The STANDING Protocol for Vertigo, Head Injury (Part 2 of 2), A History of A&E Performance with Steve Black, TTA Topical Anaesthetics for Corneal Abrasion and New Online.
This session covers the correct procedure for a thorough and comprehensive dermatological examination to allow the correct diagnosis of patients presenting to the ED with dermatological conditions.
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 67-year-old man, with a background of type II diabetes, presents with pain in the left side of his neck, lower back pain and numbness in his left arm.
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 59-year-old man presents to the ED at 11pm with acute onset severe (9/10) generalised headache and vomiting, which started at the dinner table at 5pm.
A 12-year-old girl is brought by her parents with a 1-day history of fever and lethargy, associated with a rash that has rapidly developed over the last 3 hours.
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.
A 21-year-old female presents to the ED with reduced level of consciousness. According to her family, she has been unwell for the last 3-days complaining mainly of headache. After having slept all day yesterday, her mother tried to wake her up this morning but she was unawakening from sleep.
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 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 69-year-old gentleman presented to the emergency department with odd periods of vacancy. His wife reported that on the previous day, he had 2 episodes in which he would become suddenly pale and confused for 20 to 30 seconds.
Magnetic resonance imaging (MRI) is rarely used in most EDs. However, the properties of such images can provide emergency physicians with critical information to support the optimal clinical care of many neurological disorders.
Acute, severe headache is a common symptom of patients presenting to the emergency department. In 90% of cases, the cause will be one of the primary headache syndromes.
Acute, severe headache is a common symptom of patients presenting to the emergency department. In 90% of cases, the cause will be one of the primary headache syndromes.
The seizing child is truly a scary thing to behold. If you work in the Paediatric ED, you will, at some stage, come across a child who has had a seizure, is recovering from a seizure, or is actively seizing
A 45-year-old male presents to the ED with a 3-day history of progressive weakness in his right upper and lower limbs. On examination there's observed ataxia and ocular involvement only had developed within the last 24 hours.
A 22-year-old healthy male attends ED with sudden onset of headache. He reports taking 100 mg Sildenafil before the headache started. On examination there is right arm weakness.
This session will describe calcium homeostasis. It will also examine therapeutic uses of calcium and discuss the disturbances of hypercalcaemia and hypocalcaemia.
Cranial nerve injuries are important clinical signs, which alert the examiner to intracranial pathology. This session will look at the more common traumatic and medical causes of cranial nerve injury
A 69-year-old lady presents with a 3-week history of right sided headache and jaw claudication, associated with significant reduction in vision of the right eye for 2 days.
Bell's palsy is a relatively uncommon condition presenting to primary care. Despite a benign course for most children with Bell's palsy, there are a number of serious causes of facial paralysis which can be easily missed
Bell's palsy is a relatively uncommon condition presenting to primary care. Despite a benign course for most children with Bell's palsy, there are a number of serious causes of facial paralysis which can be easily missed.
A 42-year-old man presents to the Emergency Department at 4am with a severe headache. He is pacing up and down and says that he has been woken up by a similar headache every night for the last 4 nights.
Cranial nerve injuries are important clinical signs, which alert the examiner to intracranial pathology. This session will look at the more common traumatic and medical causes of cranial nerve injury to cranial nerves
This month we have 2 sections. Part 1 we discuss Timing of endoscopy, New in EM Haloperidol for migraine, New in EM Drugs v DCC in A Fib. Part 2 we discuss the RCEM guideline on suspected internal drug traffickers
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
This month we have BET 2: Is keeping the eyes shut while fitting predictive of a psychogenic cause for seizures? And initial focused assessment with sonography in trauma versus initial CT for patients with haemodynamically stable torso trauma
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?
A 60-year-old man presented to the emergency department with a 1 week history of increasing lethargy, intermittent tingling in both arms and palpitations
This iBook (in conjunction with a series of associated clinical cases) is another manifestation of the heterogenous learning communities which constitute EM.
I remember the excitement in the room at the European Society of Emergency Medicine (EuSEM) conference in September 2018 as the room waited to hear the results of the EcLiPSE trial
The seizing child is truly a scary thing to behold. If you work in the Paediatric ED, you will, at some stage, come across a child who has had a seizure, is recovering from a seizure, or is actively seizing
Alcohol use disorder (AUD) is defined by the World Health Organisation as consuming more than 40g/day of alcohol for males and 30mg/day of alcohol for females
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?
This is a hugely common presentation in the ED and often one many doctors try to avoid
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