A 30 year old bricklayer has fallen 3m off scaffolding onto the hard ground below and has been unable to mobilise since the incident. The patient presents complaining of back pain with associated altered motor function and sensation to his lower limbs. He is GCS 15 and his vital signs read a BP 80/40 mmHg, Heart Rate 47bpm, Oxygen Saturations of 100% on room air and his temperature is 37 degrees Celsius. He has warm hands and feet. On examination you notice that power of his lower limbs is 0/5 in all myotomes and he cannot appreciate sensation below the dermatome level of T4.
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Imagine you’re on for resus in the middle of a night shift and you receive an alert for a shocked diabetic male with respiratory sepsis and DKA who has been intubated and will be arriving soon. Your initial reaction to this news probably wouldn’t worry you too much (aside from how severe the DKA must be to lead to a tube) knowing that the hard work has been done pre-hospital until the paramedic ends the call with a very casual, “Oh by the way the patient is 280kg.”
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A 18-year-old male has been brought to your rural Emergency Department suffering 35% TBSA Burns. What are the key management principles when managing this patient?
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An 80-year-old patient presents with an intentional overdose of Amlodipine. What is you approach? What are your management priorities?
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Dr Luke Phillips Emergency Physician Peer review: Dr David McCreary Welcome to Fast Fridays – a...
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Dr Hector Thomson Emergency Registrar Peer review: Dr David McCreary On a recent anaesthetic...
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Dr Eanna Mac Suibhne Emergency Registrar Peer review: Dr David McCreary The Case Gerard is a...
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In part 1 we described some of the key concepts of identifying signs of raised ICP and discussed some of the herniation syndromes. Now let’s take a look at the key concepts of managing patients with raised ICP in the ED.
During your primary survey, you noticed his left pupil is dilated and non-reactive.
THE CASE: A 60-year-old female presents to the Emergency Department with progressive shortness of breath over several months. On assessment in the emergency department, she had marked shortness of breath at rest and oxygen saturations of 90% on room air. A portable erect chest X-Ray was performed.
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