A 25 year old man presents to the emergency department with a left anterior shoulder dislocation. This is reduced satisfactory. You wonder how long his shoulder should be immobilised? There is no previous history of a dislocation.
Archives: BETs
A 34 year old female is brought into the ED with RUQ abdominal pain. She has previously been diagnosed as having symptomatic gallstones (Chronic cholecystitis) and is awaiting a cholesystectomy. You diagnose her as having biliary colic and wonder if giving her an IM NSAID (eg.40mg of piroxicam) would be appropriate instead of an opiate (IV Morphine titrated to pain with IV 10mg metoclopramide).
A 30 year old man attends the emergency department having been bitten by a dog 4 hours previously. He has puncture wounds and a 1 cm laceration on his forearm. His wounds are thoroughly cleaned and a dressing applied. You want to know whether to prescribe antibiotics as well.
No evidence for either curettage or silver nitrate for pyogenic granulomas on the hand
A 23 year old woman attends the emergency department with a strange growth on the end of her finger. She cut herself on glass some 6 weeks previously. Examination reveals a lesion with the appearance of a pyogenic granuloma. You wonder whether you should remove the lump surgically or chemically.
A 27 year old man attends the Emergency Department having been involved in a fight. He had been hit on the nose and has an obvious displaced nasal fracture without septal haematoma. As yet there is no gross swelling. You wonder whether immediate reduction would be better than delayed reduction.
No evidence for either Collar and cuff or sling after fracture of the clavicle
A 23 year old male presents to the emergency department following a fall on the outstretched hand. X-rays reveal a mid clavicular fracture. You know that a figure of eight bandage is of no benefit but are unsure whether a sling or a collar and cuff is best.
A 21 year old man presents on a saturday morning having been involved in a drunken brawl the night before. He has a painful swollen right (dominant) hand. An x-ray reveals a fracture of the neck of the fifth metacarpal with some angulation.
A 3 year old child attending the emergency department with moderately severe croup. I know that croup responds to steroid therapy, but I want to know whether oral dexamethasone is a better treatment than nebulised budesonide.
A 45 year old man presents to A&E with a 2/7 history of painful left elbow. He admits to undertaking a lot of gardening in the previous 3 weeks. Clinical examination reveals tenderness over the lateral humeral epicondyle and pain on resisted extension of the wrist. A clinical diagnosis of lateral epicondylitis is made. The patient is anxious to return to work and has heard that an injection can cure him.
A 30 year old man presents having been involved in a front end collision while driving a car at 40mph. He is found to have sternal tenderness and an x-ray reveals a fracture. There are no other significant injuries.
A 60 year old man attends the emergency department with chest pain. He also gives a history of belching since the onset of the pain. His initial ECG is normal. You wonder if the symptom of belching has any prognostic value in the diagnosis of cardiac chest pain, or is more suggestive of a gastrointestinal cause.
IVRA (Biers block) is better than haematoma block for manipulating Colles’ fractures
A 71 year old lady presents to the A+E department following a fall on the outstretched hand. X-rays reveal a Colles fracture with shortening and dorsal angulation requiring manipulation. Having worked in several different departments you have experience of reducing these fractures with either Biers block or a Haematoma block. The department is better and you think that it will be quicker to manipulate the fracture using a haematoma block but you wonder which is best for your patient.