History Features requiring urgent referral Contact lens wearer Previous eye surgery or refractive surgery Decreased vision Severe pain Nausea and vomiting Cloudy or opaque cornea Dendritic ulcer Hypopyon (pus in the anterior chamber) Nonreactive pupils or RAPD Ocular trauma Persisting or worsening symptoms Chemical to eye Blunt trauma Signs of an inferior blowout fracture Ecchymosis/oedema […]

Overview Differential diagnosis of altered level of Consciousness – AEIOUTIPS) Remember Confusion is not specific to delirium; it may be found in other psychiatric disorders, such as dementia or depression. Difference between Dementia and Delirium   Dementia Delirium Onset Sub-acute Acute Conscious level Normal Fluctuates Hallucinations Late event Common Agitation/agression Uncommon until late Common Thought form Poverty […]

Overview Differential diagnosis causing bradycardia History Examination Acute Management Investigations

Overview  Abdominal trauma can result in injuries that are intraperitoneal and retroperitoneal Abdominal trauma is divided into blunt and penetrating mechanisms. Blunt abdominal trauma involves a crushing force that causes disruption of solid viscera (spleen or liver) or hollow viscera (intestine). These injuries are most common after falls or MVCs. Penetrating abdominal trauma occurs most […]

Overview  Thoracic trauma causes injuries to the chest wall, lungs, great vessels, and heart. It is clinically divided into blunt and penetrating injuries. PAMD Preparation Assessment – Primary Survey – ABCDE INVESTIGATIONS Bedside Laboratory Imaging ECG FBC X-Ray – Neck, Thorax, Pelvis Ultrasound (FAST)? EUC Head CT scan (non-contrast) Blood glucose Cross match Chest CT   […]

Overview  Devastatingly disabling injury. Can be missed as ambulant patients may have an  unstable vertebral injury. Up to 10% of unconscious patients have a significant vertebral injury. Most common cause of spinal injuries include MVA, Falls and pedestrian on roads. Ask yourself: PAMD Preparation Assessment – Primary Survey – ABCDE INVESTIGATIONS Bedside Laboratory Imaging Blood sugar FBC X-Ray – Neck, Thorax, Pelvis ECG EUC Head CT scan (non-contrast) VBG Cross match C-spine CT FAST Urinalysis MRI – […]

Overview PAMD Preparation  Assessment – Primary Survey – ABCDE Warning Signs of Severe Head Injury GCS <8 Deteriorating GCS Unequal pupils Lateralizing signs   INVESTIGATIONS Laboratory Imaging FBC X-Ray – Neck, Thorax, Pelvis EUC Head CT scan (non-contrast) Cross match Ultrasound (FAST)? Urinalysis MRI – axonal injury is suspected Pregnancy test Angiogram? Serum lactate   […]

Overview Potassium (K+) is an important ion in the body. K+ is found mainly intracellularly (inside the cells) whereas sodium (Na+) is found extracellularly (outside the cells). Therefore: As the pH rises , K+ is shifted intracellularly and the serum levels falls; conversely when serum pH decreases, intracellular K+ shits extracellularly into the vascular space […]

POISONING “All things are poison and nothing is without poison, only the dose permits something not to be poisonous.”–Paracelsus Overview  Children are curious and explore their world with all their senses, including taste. As a result, the home and its surroundings can be a dangerous place when poisonous substances are inadvertently ingested – every year […]