Emergency Medicine

CHEST PAIN 56 General Medical Emergencies 2 Typical symptoms include leg pain, swelling, tenderness and redness or discoloration ...

CHEST PAIN General Medical Emergencies 57 6 Send blood for D-dimer only when the pre-test probability is low. (i) Discharge the ...

CHEST PAIN 58 General Medical Emergencies 4 Establish venous access with a large-bore (14- or 16-gauge) i.v. cannula, and send b ...

CHEST PAIN General Medical Emergencies 59 3 Refer the patient to the medical team for bed rest and cardiac monitoring if there a ...

CARDIAC ARRHYTHMIAS 60 General Medical Emergencies (a) admit the patient to rule out ACS with serial ECGs and troponins, if ther ...

CARDIAC ARRHYTHMIAS General Medical Emergencies 61 2 Exclude myocardial ischaemia from ACS as a priority (see p. 44). 3 Consider ...

CARDIAC ARRHYTHMIAS 62 General Medical Emergencies 3 Provide pain relief if needed with GTN 150–300 g sublingually for coronary ...

CARDIAC ARRHYTHMIAS General Medical Emergencies 63 (iv) Narrow-complex supraventricular tachycardia (SVT) When regular this may ...

Breathless Patient 64 General Medical Emergencies commence heparinization with LMW heparin such as enoxaparin 1 mg/kg s.c. or u ...

BREATHLESS PATIENT General Medical Emergencies 65 Acute asthma DIAGNOSIS 1 Ascertain the precipitating factors in the present at ...

BREATHLESS PATIENT 66 General Medical Emergencies 3 Add ipratropium (Atrovent™) 500 g to a second dose of salbutamol 5 mg via t ...

BREATHLESS PATIENT General Medical Emergencies 67 6 Ta ke a n A BG only if the patient is deteriorating. ABG markers of a life- ...

BREATHLESS PATIENT 68 General Medical Emergencies (iii) Finally remember tuberculosis, especially in alcoholism or social depriv ...

BREATHLESS PATIENT General Medical Emergencies 69 Table 2.6 SMART-COP score for assessing severity, once community-acquired pneu ...

BREATHLESS PATIENT 70 General Medical Emergencies 3 Mild CAP (i) Young, fit adults with single lobe involvement may well be able ...

BREATHLESS PATIENT General Medical Emergencies 71 (b) use moxifloxacin 400 mg daily i.v. with azithromycin, if the patient has p ...

BREATHLESS PATIENT 72 General Medical Emergencies 9 Perform bedside lung function testing for PEF, FEV 1 and FVC to compare with ...

BREATHLESS PATIENT General Medical Emergencies 73 5 A spontaneous primary pneumothorax may cause only slight dyspnoea and pleuri ...

BREATHLESS PATIENT 74 General Medical Emergencies (iii) Perform needle aspiration if the air leak has enlarged, or the patient d ...

BREATHLESS PATIENT General Medical Emergencies 75 (ii) Alternatively use a small standard size 16–22 French gauge drain directed ...