Essentials 1 An avulsed tooth reimplanted within 30 minutes has a 90% chance of survival. 2 Dental caries is the most common cause of dental emergency attendance. 3 Dental caries requires analgesia in the emergency department and referral to a…
Essentials 1 Always test and record visual acuity: use pinhole if usual spectacles are not available. 2 Chloramphenicol eyedrops are not a universal panacea. 3 Pain: sharp/scratchy = anterior (cornea or conjunctiva); aching = intraocular (intraocular pressure or inflammation) Trauma…
Essentials 1 Emergency dermatology presentations may be divided into potentially life-threatening dermatoses, vesiculo-bullous conditions, petechial and purpuric rashes, and inflammatory dermatoses such as eczema, urticaria and psoriasis. 2 Potentially life-threatening presentations include Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), Sweet syndrome,…
Essentials 1 The mechanism of injury and biomechanics predict the soft-tissue damage caused. 2 Soft-tissue injuries can be as debilitating and painful as fractures in the same area, and may take longer to heal. 3 The so-called ‘minor injury’ can…
Essentials 1 Polyarthritis is a common adult rheumatological presentation with a wide differential diagnosis. 2 Recording articular and extra-articular involvement facilitates decision making, particularly with regards to patient admission. 3 Joint aspiration is paramount for both diagnosis and excluding a…
Essentials 1 Presenting features alone, including absence of fever, do not reliably exclude a septic arthritis, especially in older people and those who are immunosuppressed. 2 Synovial aspirate in appropriate pathology transport media should be performed prior to commencing antibiotics…
Essentials 1 Rheumatological emergencies relate to the disease, extra-articular manifestations of the disease or toxicity from treatment. 2 Infection must be considered and promptly treated in patients on antirheumatic and immunosuppressive medication, including those on biological therapies. Introduction Rheumatological conditions…
Essentials 1 The decision to transfuse packed red cells should ultimately be based on the knowledge that the patient’s oxygen carrying capacity has dropped to an unacceptably low level. 2 The administration of blood products carries substantial risk. The emergency…
Essentials 1 Haemophilia is a disorder that should be managed by the emergency physician in consultation with the nearest haemophilia centre. 2 Patients should carry their treatment regimen cards with them. If they do not, they should be encouraged to…
Essentials 1 A low platelet count detected on automated blood count should always be confirmed by examination of the blood film prior to further investigation or treatment. 2 The cause of isolated thrombocytopaenia can often be determined by a careful…