A 2-year-old boy is brought into the Emergency Department one evening and his parents say he has been feeling hot the last 24 hours, and has a sore throat and is feeling irritable. They have measured his temperature at home using an oral thermometer and it read 39oC. You wonder if the tympanic thermometer in the Emergency Department is a more accurate way of measuring his temperature.
A 2-½ year-old girl has been brought to the Emergency Department with a simple febrile convulsion with unclear focus of infection on examination. She does not appear septic. Her parents say she is potty training and have noticed her urine has smelt strong the past day or two. You test a sample of her urine and diagnose an UTI. You wonder if an UTI is a common cause of febrile convulsions.
A 3-year-old boy has been brought to the Emergency Department after a convulsion at home, which has now resolved. His parents say he has been hot, sleepy and irritable that morning, and has been crying when his bedroom light was turned on. After investigation, meningitis is diagnosed and treated. You wonder how commonly meningitis is a cause of febrile convulsions.
Do all children presenting with their first febrile convulsion need hospital admission?
A 2-year-old girl has been brought to the Emergency Department having had her first febrile convulsion, which has now resolved. On examination she has a runny nose and a cough and she has been off her food. You suspect she has a viral URTI. She is her parent's first child and they are very concerned and anxious to know whether she has anything serious and whether this will happen again. You wonder whether you should admit her, or give the parents advice and discharge her.
Are prolonged febrile convulsions associated with recurrent febrile convulsions?
A 4-year-old girl has been brought into the Emergency Department having had a febrile convulsion lasting 25 minutes. She has not had a febrile convulsion before. Her parents are extremely worried and are asking if this will cause her any problems in the future. You wonder what advice to give them.
Do antibiotics work for tonsillitis caused by infectious mononucleosis?
An 18 year old male with known infectious mononucleosis presents with sore throat, anterior cervical lymphadenopathy, fever and tonsillar exudates. The SHO wonders if antibiotics would help?
A 69 year old male with a history of heart failure presents to the A & E department with acute onset of shortness of breath. The clinician wonders whether it would be better to treat him with nitroglycerin or a combination of furosemide and morphine.
A 20 year old patient presents to the A & E department with severe pulmonary oedema of cardiac origin. You wonder whether diuretic and ace-inhibitor combination therapy is better than either of them alone.
A 35 year old man came into A&E complaining of a sore throat. He had a fever, anterior cervical lymphadenopathy and tonsillar exudates. He had returned from Russia 1 week ago and was unsure of his vaccination status.
Is prescription of antibiotics or surgical intervention best for recurrent tonsillitis?
A 7 year old child presents to A&E with severe tonsillitis for the fourth time in 10 months. As they are discharged with antibiotics the SHO wonders if she should write to the GP suggesting ENT referral.
A 35 year old presents with an acute sore throat, although no tonsillar exudates, fever or lymphadenopathy. He asks what is the best pain relief?
A 28 year old male dentist presents to the emergency department following a suspected Amitriptyline overdose. You remember that tricyclic antidepressants delay gastric emptying and wonder whether gastric lavage or activated charcoal would be of benefit
Is a cast as useful as a splint in the treatment of a distal radius fracture in a child
An eight year old child presents to the emergency department with signs and symptoms of a fractured wrist. radiology confirms a fracture of the distal radius.
Treatment for fractures of a lateral condyle of the humeus in a child
an eight year old child presents to the emergency department with signs of a fracture. Radiology shows a fracture of the lateral condyle of the humerus.
Best position of immobilisation in a greenstick fracture of the distal radius
an eight year old child presents to the emergency department with a suspected wrist fracture. radiology confirms a greenstick fracture of the distal radius. treatment is with the application of a plaster of Paris cast, but in which position should the forearm be immobilised (pronated, neutral or supinated)
Influence of clinical information on the diagnosis of a wrist fracture in a child
An eight year old child presents to the emergency department with swelling, local tenderness, pain and crepitus. Can this clinical information accurately diagnose a wrist fracture?
Is penicillin V or cephalosporin more effective for sore throats?
A 24 year old man presents with a sore throat, anterior cervical lymphadenopathy, fever and tonsillar exudates. He is prescribed penicillin V but the SHO wonders if cephalosporin would be more effective?
Should sore throats be investigated to reduce inappropriate antibiotic prescription?
An 18 year old presents to A&E with a sore throat, fever, tonsillar exudates and anterior cervical lymphadenopathy and no history of a cough. She is prescribed antibiotics but should she be investigated further?
Is oral acyclovir effective for treatment of primary herpetic infection?
A seven year old child presents with primary oropharyngeal infection. The SHO wonders if if oral aciclovir will be of use or if conservative treatment should be prescribed.
Is HIV prophylaxis required in all patients with human bites?
A 35 year old prison guard was brought into the emergency department after being bitten by a HIV- positive inmate 4 hours ago. There was a superficial laceration wound on his right leg that bled profusely when bitten. You wonder whether he will benefit from HIV prophylaxis.