Mental Health in the ED
The assessment of patients with mental health problems is a necessary skill for working in the ED, self harm is a common presentation and we are seeing more of it. Suicide risk assessment can also feature as an OSCE base in the college exams. RCEM and RCPsych have also launched the CLEAR campaign for Emergency Care of Mental Health Problems (see image).
Its not just about our patients...
Times are hard and there are lots of stressors on Medical Staff at the moment, there are resources out there to help if you are struggling. Please look after each other and speak up if you need help or consider contacting some of the organisations below:
ITP typically presents with a sudden appearance of a petechial rash, spontaneous bruising, and/or bleeding in an otherwise well child.
Anaemia is a common incidental finding in the ED. Symptoms may include pale skin, fatigue, breathlessness and many more...
HSP is a multi-system vasculitic disorder which can affect skin and joints. Children will require a urine dipstick, BP and assessment of fluids.
Peritonsillar abscess (aka Quinsy) is a collection of pus in the peritonsillar space as a result of tonsillitis causing irritation.
Fractures of the facial bones are a common presentation to the ED but can lead to airway problems.
Tonsillitis is inflammation of the palatine tonsils (including the pharynx and adenoids) as a result of either a bacterial or viral infection.
Pre-tibial lacerations usually affects the older population when the skin over the shin becomes thin and friable, allowing small injuries to cause the skin to tear for easily.
Nicotine poisoning has proven to be fatal in children since e-cigarettes were introduced several years ago. A fatal dose can be as little as 1mg/kg.
Careful calculation of elemental iron is important to determine toxicity. Severe overdose can range from 75-150 mg/kg and be potentially fatal.
Local Anaesthetics (LAs) are used widely in Emergency Medicine. Toxicity occurs rapidly when LAs enters systemic circulation.
Naloxone is an opioid antagonist used to reverse the effect of opioid intoxication. Following reversal, patients need to be observed for at least 6 hours longer.
SCIWORA: Spinal Cord Injury Without Radiological Abnormality accounts for 6-19% of spinal cord injuries in children, and 9-14% in adults.
Safeguarding and promoting the welfare of children is the responsibility of EVERY member of staff in the NHS.
It’s always important to remember when considering a CT: there is no safe low level of radiation exposure!
Hip or neck of femur fractures often result from a fall onto the hip and are mostly frailty-related.
Precipitous or ‘unexpected’ deliveries are a stressful time, but they are infrequent in most UK Emergency Departments.
Pelvic Inflammatory Disease (PID) is an infection of the female genital tract most common in the 20 to 29-year-old age group.
Newborn Life Support (NLS) provides a framework for managing newborn infants who need support at time of birth.
Perimortem C-section is an emergency surgical procedure performed on a pregnant woman in cardiac arrest in order to save her life.
Pre-eclampsia affects pregnant women from around Week 20 until soon after birth. If untreated it can progress to seizures (eclampsia) which can be life-threatening.
Buckle or Torus fractures are a common type of forearm fracture seen in children between the ages of five and ten.
The clavicle is commonly fractured following a fall onto the shoulder, though occasionally resulting from a fall onto an outstretched hand.
A Toddler’s Fracture is typically a spiral fracture of the tibia when a child falls and twists their leg with low energy.
The Ottawa Knee Rules are a set of criteria, which guide a clinician as to when an x-ray of the knee is required.
When risk assessing mental health patients, don’t just think ABCDE... think PEPI and SLIPA!
HEEADSSS is a time-tested strategy for obtaining a Psychosocial Review of Systems (PROS) for adolescent patients with mental health concerns.
What to do when patients are refusing life-saving treatment.
Status Epilepticus is generally defined as any single or multiple convulsions lasting 30 minutes or more.
Febrile Convulsions are generalised seizures affecting 1 in 20 children between the ages of 6 months and 5 years.
The ROSIER score is used to distinguish between suspected stroke and stroke mimics.