A 23 year old women started a graduated training programme for 10 weeks since she set her goal to run 5 km nonstop. While running, she encounters stabbing pain under the lower edge of the ribcage that is inconvenient to continue her training. Therefore, she asks you if exercise-related transient abdominal pain (or stitch) is preventable e.g. by not drinking fluids before and during the run.
Archives: BETs
A 65 year old patient attends the Emergency Department with a fever and symptoms suggestive of urinary sepsis. He has a T 39.1 and HR 120-140 irregularly irregular. ECG confirms new-onset atrial fibrillation. You decide to rate control this patient with bisoprolol. Whilst doing this, you consider the need to anticoagulate the patient to prevent stroke.
What are the clinical features of Salvia divinorum toxicity?
An 18-year-old male is brought to your Emergency Department by his mother with a chief complaint of \"acting odd\". The patient has been intermittently unresponsive to verbal stimuli, laughing uncontrollably, and appears to hallucinating. In his front pocket, you find a crude pipe and a foil package labeled \"Saliva 10x\" (sic). You begin to wonder what clinical suprises this patient may have in store for you.
Use of NSAIDs to provide symptomatic relief in uncomplicated UTI.
A 44 year old female attends the Emergency Department with a two day history of worsening dysuria and urinary frequency. She is systemically well, but urinary dipstick testing confirms the presence of a urinary tract infection. The patient states that she does not want to take antibiotics and you wonder whether NSAIDs will provide adequate relief to the patient?
A 28 year old man with Hodgkin’s lymphoma presents to the Emergency Department with increasing pain, swelling and erythema of the forearm following intravenous administration of doxorubicin a few hours ago at your local specialist cancer treatment centre. The pain was described as severe and constant with localised swelling, erythema, warmth and limited movement of the wrist. You suspect extravasation of anthracycline from the cannula site and as you initiate local measures of limb elevation and cooling, you wonder if emergency intravenous administration of dexrazoxane may be beneficial in reducing the risk of soft tissue necrosis and subsequent debridement.
A 3-year-old boy comes in with intermittent bouts of severe abdominal pain. You are thinking of intussusception as the most likely diagnosis. It is night time and in your institution, the access to a formal ultrasound is limited at this time of day. You have heard of case reports of intussusception diagnosed by emergency physicians using bedside ultrasound. You wonder if there is any good evidence at diagnosing intussusceptions with this modality and you decide to search the available literature.
A 31-year-old man was working in a local chemical factory when he splashed himself with hydrofluoric acid to the eye. He attends the emergency department and you arrange for copious water irrigation and oral pain relief. You have the heard about the Hexafluorine antidote solution and wonder whether there is any evidence for its use.
Should the type of fish bone ingested guide need for soft tissue neck Xray?
A patient comes in to the accident and emergency department complaining of foreign body sensation after eating fish for dinner. The fish bone is not visible on soft tissue plain radiograph of the neck. Does knowing the species of the fish consumed help the clinician make a decision on referral for endoscopy?
What prognostic factors can predict outcomes of methamphetamine body stuffers?
A 20-year-old man presents to the emergency department with police officers after he was witnessed swallowing a bag of methamphetamine. He denies ingestion of any other substances and has no specific complaints at this time. The time of ingestion is 30 min before evaluation. His vital signs are: blood pressure 134/86, pulse 94, heart rate 18, temperature 37.6°. You wonder whether to attempt actively to expedite the passage of the toxin or if conservative management is acceptable.
Up to 70 degrees 5th MC neck fracture angulation can be managed with neighbour strapping.
A 25yrs old gentleman presents to the ED after punching into a wall, xrays show boxer fracture with 60degrees volar angulation. Can he be managed conservatively with neighbour strapping or he needs surgery?
Intraosseous Adenosine Terminates Paroxysmal Supraventricular Tachycardia in Children.
A one-year-old girl presents to your Emergency Department with palpitations. The ECG recording is consistent with supraventricular tachycardia. You attempt to gain venous access multiple times but are unsuccessful. You wonder if the intraosseous delivery of adenosine is as effective as the intravenous one in terminating the arrhythmia
A 55 year old female presents to the ED with the complaint of fever, chills, weakness. Upon presentation she appears pale Vitals are Temp 39, HR 105, RR 22 and WBC count 13,000. Given this patient meets SIRS criteria, will a procalcitonin level accurately diagnose serious bacterial infection?
A 23 year old female with a diagnosis of Joint Hypermobility Syndrome is assessed by a Physiotherapist in an out-patient department. The patient is presenting with pain, which is decreasing her function. You wonder whether acupuncture is an effective treatment adjunction to use with this patient to decrease pain and increase her function.