Essentials 1 Morbidity and health costs are reduced by distinction of medical from psychiatric causes of mental disorder presentations to emergency departments. 2 Always ask if any medical condition exists in addition to the psychiatric complaints. This will identify most…
Essentials 1 The number of patients presenting to the emergency department (ED) with mental health problems is increasing. 2 Regardless of diagnosis and presentation, an initial assessment must be performed within the first few minutes of an individual’s arrival in…
Essentials 1 Perform a rapid assessment of any pregnant patient arriving in labour at the emergency department to decide the most appropriate site for management. 2 Emergency department staff must be prepared to provide newborn resuscitation following an emergency delivery.…
Essentials 1 Pre-eclampsia is hypertension with organ-system dysfunction unique to the second half of pregnancy. 2 Maternal and foetal demise are inevitable and can only be stopped by pregnancy termination. 3 Early diagnosis is crucial as the rate of deterioration…
Essentials 1 Up to 5% of pregnant women will have significant bleeding after 20 weeks’ gestation. 2 Resuscitation of the mother followed by ultrasound localization of the placenta are the priorities of management for patients with heavy vaginal bleeding after…
Essentials 1 Approximately 25% of all clinically diagnosed pregnancies are associated with bleeding in the first 12 weeks, of which approximately 50% of cases will be due to a failed pregnancy. 2 Ectopic pregnancy occurs at a rate of around…
Essentials 1 Start the assessment of any patient with vaginal bleeding by excluding pregnancy. 2 Locate the anatomical site of bleeding and assess the severity looking for signs of hypovolemia and shock. 3 Familiarize yourself with the PALM-COEIN classification system.…
Essentials 1 Pelvic inflammatory disease (PID) is infection and/or inflammation of the upper genital tract. 2 The clinical features cover a spectrum of presentations that depend on the extent of infection and/or inflammation, the anatomical structures involved and the specific…
Essentials 1 History, abdominal and age-appropriate pelvic examination guide diagnosis. 2 History and examination can be supplemented, but not replaced, with appropriate investigations. 3 A normal pelvic examination should not preclude gynaecological referral, even in the absence of other findings.…
Essentials 1 Make sure that the ear-nose-throat (ENT) supplies in your emergency department are well stocked and maintained. 2 Develop agreed pathways/protocols with your local ENT department for common and serious presentations. 3 A foreign body in the ear requires…