A 65-year-old man presents with shortness of breath, was subsequently found on electrocardiogram to have acute onset rapid ventricular response to his chronic atrial fibrillation with a ventricular rate of 160. The patient’s blood pressure was 72/42 mm Hg. Anteroposterior transcutaneous pads were placed on the patient’s chest placement for electrical cardioversion. You wonder if anterolateral pad placement might be more effective for converting atrial fibrillation.
A 60-year-old male with noncontributory past medical history presents with two weeks of productive cough. His initial course of illness included additional upper respiratory tract infection symptoms, all of which improved within the first five days apart from the cough. He has an albuterol inhaler and Tessalon Perles available at home though has not perceived any significant benefit from these therapies. The patient has stable vitals, unremarkable exam apart from frequent productive cough, unremarkable basic labs (COVID negative), and chest x-ray negative for consolidation. He is diagnosed with uncomplicated acute bronchitis. He is frustrated with the frequent coughing and asks if there are any other available therapies. Oral steroids are considered.
A 35-year-old man was sent to the emergency department after being hit by an electric car. He complained of right chest pain, no tenderness in the ribs and normal chest X-ray, but the patient still unwell consider sending him for a chest CT but your colleague told you that you could first scan the chest ultrasound for diagnose occult pneumothorax. You want to know whether patients with negative chest X-ray can diagnose the presence of occult pneumothorax by ultrasound.
Following a failed extubation on day 3 of life on a neonate born at 25 weeks gestation, an echocardiogram was performed that showed a hemodynamically significant patent ductus arteriosus (PDA). A clinical decision was made to treat the PDA with intravenous paracetamol. A recent review article showed an association between prenatal and neonatal use of paracetamol with adverse neurodevelopmental outcomes. Can this be true for paracetamol use for PDA closure?
Tranexamic acid for Neck of Femur Fractures in the Emergency Department
A 72-year-old woman presents to the emergency department (ED) with hip pain after a fall from standing. She is unable to weight bear. You notice extensive bruising around her left hip and an X-ray confirms a neck of femur fracture. You wonder if giving tranexamic acid (TXA) in the ED would improve her outcome when she later undergoes surgery.
Predicting Re-attendance of Older Adults to the Emergency Department
A 70 year-old gentleman has presented to the Emergency Department (ED) for the 3rd time in 7 months. Your SHO insists that he should be admitted or he will just come back again. What factors in his assessment suggest that he is more likely to re-attend?
A 42 year old male presents to the ED with opioid withdrawal symptoms of moderate severity. He is hoping to be prescribed opioid agonist therapy treatment with buprenorphine. He has no other complaints.
A 65 year old man who has a history of AF on apixaban presents to the emergency department with a minor head injury (GCS 15, no loss of consciousness, no neurological deficits) after a trip and fall on the street. He does not have a headache, did not vomit, there were no haematoma or laceration wounds on his head. Does he need to be admitted for 24 hours neuro-observation?