Emergency Medicine

Upper Gastrointestinal Haemorrhage 76 General Medical Emergencies (i) Add GTN 200 mg to 500 mL of 5% dextrose, i.e. 400 g/mL, u ...

UPPER GASTROINTESTINAL HAEMORRHAGE General Medical Emergencies 77 (vi) Miscellaneous, including gastric neoplasm, blood coagulat ...

Diabetic Coma and Pre-coma 78 General Medical Emergencies 3 Start a proton-pump inhibitor if peptic ulcer disease is likely. Giv ...

DIABETIC COMA AND PRE-COMA General Medical Emergencies 79 4 Establish venous access and send blood urgently for FBC, ELFTs, bloo ...

Altered Conscious Level 80 General Medical Emergencies (i) It may be considered if the pH remains <7.0, particularly with cir ...

ALTERED CONSCIOUS LEVEL General Medical Emergencies 81 The following categories are covered, although they may overlap: ● Confus ...

ALTERED CONSCIOUS LEVEL 82 General Medical Emergencies (c) post-ictal state, complex partial (temporal lobe) seizures (d) cerebr ...

ALTERED CONSCIOUS LEVEL General Medical Emergencies 83 (v) Blood cultures, MSU. (vi) ECG, CXR. (vii) CT brain scan. (viii) Lumba ...

ALTERED CONSCIOUS LEVEL 84 General Medical Emergencies MANAGEMENT 1 Avoid the temptation to simply sedate the confused patient, ...

ALTERED CONSCIOUS LEVEL General Medical Emergencies 85 Alcohol-related medical problems Acute alcohol intoxication is causally r ...

ALTERED CONSCIOUS LEVEL 86 General Medical Emergencies 3 Other general medical problems in patients who drink (i) Epileptic seiz ...

Acute Neurological Conditions General Medical Emergencies 87 (iii) Control seizures with midazolam 0.05–0.1 mg/kg up to 10 mg i. ...

ACUTE NEUROLOGICAL CONDITIONS 88 General Medical Emergencies 2 A faint may be difficult to distinguish from a seizure or acute v ...

ACUTE NEUROLOGICAL CONDITIONS General Medical Emergencies 89 (vi) Vasovagal (neurocardiogenic) – ‘simple’ faint, triggered by he ...

ACUTE NEUROLOGICAL CONDITIONS 90 General Medical Emergencies 3 Exclude all the following ‘acute symptomatic’ secondary causes of ...

ACUTE NEUROLOGICAL CONDITIONS General Medical Emergencies 91 5 Discharge home a known previous epileptic if: (i) A rapid, full r ...

ACUTE NEUROLOGICAL CONDITIONS 92 General Medical Emergencies MANAGEMENT 1 Give the patient oxygen via a face mask, and aim for a ...

ACUTE NEUROLOGICAL CONDITIONS General Medical Emergencies 93 (c) cerebral hypoxia (d) drug toxicity, e.g. theophylline. (iii) Su ...

ACUTE NEUROLOGICAL CONDITIONS 94 General Medical Emergencies 4 Examine the pulse rhythm, heart sounds, blood pressure (in both a ...

ACUTE NEUROLOGICAL CONDITIONS General Medical Emergencies 95 2 Deciding who to admit can be difficult. Refer the patient for imm ...