Surgical emergencies. Dr Rebecca Thomas
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This document provides guidelines from a surgical registrar on when and how to contact them regarding surgical emergencies that present to the emergency department. It outlines some key situations that should prompt a call, such as a hole or blockage in something, something in the wrong place, or significant infection or inflammation. It also provides advice on what information to provide when calling, including who you are, where you're calling from, and what you need from the registrar. The document gives some brief overviews of specific conditions like hernias, pancreatitis, ischemic gut and limb, and massive GI bleeds.
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This document summarizes 5 common medical emergencies: cardiac arrest, respiratory arrest, airway obstruction, burns, and soft-tissue injuries. It provides details on the symptoms and treatment for each emergency. Key points include that cardiac arrest results from an electrical disturbance and stops heart function/blood flow, respiratory arrest occurs when breathing ceases, airway obstruction can block breathing, burns are classified by degree of skin damage, and soft-tissue injuries involve muscle/tendon damage. Proper treatment may involve CPR, intubation, cooling burns, or RICE therapy depending on the emergency type. Automated external defibrillators can treat cardiac arrhythmias through defibrillation.
Common urological emergencies
This PPT is mainly for MBBS as well as Interns. They can easily differentiate Traumatic & Non-traumatic Injuries of Urogenital system in casualty.
Acute appendicitis
Thank you for the summary. Acute appendicitis is a common surgical emergency that requires timely diagnosis and management to prevent complications. A high index of suspicion is needed given its varied presentations.
Adult Emergency
The document summarizes the current emergency service landscape in Qatar. It notes there is one major tertiary hospital, three district general hospitals, and emergency departments at other specialty hospitals. There are also walk-in clinics, workers clinics, and private providers. The document discusses centralization of services for trauma, stroke, and infectious disease. It identifies current difficulties like lack of inpatient beds, poor facilities, recruitment issues, and suboptimal training programs. Recommendations include improving coordination between emergency services, accrediting emergency departments and practitioners, developing national guidelines, and centralizing high-risk services with good evidence like trauma, stroke, and STEMI based on volume and skills maintenance needs.
Emergency and critical care veterinarian
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Our errors in diagnosing abdominal pain slides
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Medical Emergencies
This document discusses the management of various medical emergencies. It covers topics like airway management, breathing issues including asthma, COPD, pneumothorax and ARDS. It also discusses circulation emergencies such as cardiac arrest, shock and myocardial infarction. For each topic, it provides guidance on diagnosis, treatment principles and protocols for first responders. The overall aim appears to be educating first responders and medical professionals on best practices for treating common life-threatening conditions in emergency situations.
Practical general surgery
This document provides a list of topics related to general surgery of the head and neck region organized into terms. The topics include various wounds, infections, cysts, lesions, and diseases of the oral cavity, lips, tongue, teeth, gums, jaws, salivary glands, lymph nodes, and thyroid gland. Examples given include abscesses, ulcers, hematomas, fractures, cysts, tumors, cancers, and conditions like mumps and goiter.
Intro to er nursing
This document provides an overview of the scope of emergency room nursing. It discusses the standards and responsibilities of ER nurses, which include comprehensive patient assessment, diagnosis, treatment, and evaluation. ER nursing requires knowledge in various medical areas as well as skills like triage and emergency preparedness. The document also outlines how ER nurses are involved in community education through primary, secondary, and tertiary prevention efforts. It discusses national patient safety goals and core measures that ER nurses must follow to improve quality of care. Finally, it lists several certifications that ER nurses can obtain.
Urological emergencies
references : Smith’s general urology Emil A.tanagho, jack W.McAninch
ارولوژی عمومی دکترناصرسیم فروش، دکتر اکبرنورعلیزاده
Common programme - 18 jan 17
This document discusses the management of surgical emergencies like shock and gastrointestinal bleeding. It begins by outlining the signs of shock and appropriate initial screening tests for surgical emergencies which include FBC, electrolytes, blood glucose, coagulation profile, and blood grouping. Upper gastrointestinal bleeding causes and management are then outlined, including endoscopic therapies for bleeding peptic ulcers. Lower gastrointestinal bleeding causes, classification as major vs minor, and investigation approach are also summarized. Finally, approaches to common urological emergencies like hematuria, urolithiasis, BPH, bladder cancer and renal cell carcinoma are presented.
Common Emergencies
The document provides information on common emergencies including environmental, medical, and childbirth emergencies. For environmental emergencies, it describes hypothermia and its stages, signs and symptoms, and first aid. It also outlines heat emergencies like heat cramps, heat exhaustion, and heat stroke - their causes, signs, symptoms, and treatment. For medical emergencies, it discusses strokes, diabetes, seizures, and febrile seizures. It also covers emergency childbirth procedures and complications that may arise.
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This document provides guidelines for emergency department clinicians on when to call a surgical consult. It lists several situations that warrant a surgical consult, including if there is a hole in something, something where it shouldn't be, something blocked, or something badly infected or inflamed. It also notes that a consult should be called if there is significant concern from the clinician or colleagues about the patient's condition. The document provides some examples for each situation and gives advice on what to do first when evaluating a potential surgical patient, such as taking a history, exam, and initial investigations. It also provides tips on what to say when calling the surgeon and briefly discusses some specific conditions like hernias, pancreatitis, and ischemic gut or limb.
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acute abdomen DPT.pptx
The document discusses abdominal anatomy, physiology, and various conditions that can cause abdominal pain. It provides information on assessing and caring for patients with abdominal pain. Key points include performing a thorough history and physical exam to identify any life-threatening conditions; maintaining the airway, providing oxygen, positioning the patient comfortably, and transporting them promptly for further evaluation and treatment. The primary role of EMTs is to assess and report findings, not make a specific diagnosis, as the abdomen contains many organs and causes can be complex.
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This document provides tips for using a PowerPoint presentation (ppt) for active learning sessions. The main points are:
1. The ppt can be freely downloaded, edited, and modified.
2. Many of the slides are intentionally blank except for the title to allow students to provide input on that topic.
3. The instructor should first show blank slides and ask students what they know about that topic, then show the content slide.
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The document discusses acute abdomen and intestinal obstruction. Acute abdomen is characterized by sudden onset of abdominal pain, tenderness and muscle rigidity, usually requiring emergency surgery. Intestinal obstruction occurs when there is restriction to the normal passage of intestinal contents, which can be paralytic or mechanical. Mechanical obstruction is further classified by speed of onset, site, nature, and cause. Common causes include hernia, adhesions, tumors, and fecal impaction. Clinical features include colicky pain, distension, constipation and vomiting. Investigations include abdominal x-rays and CT scans to determine the level and severity of obstruction. Treatment depends on the underlying cause but may require surgery for complete or strangulating obstructions.
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http://drvijayantgovinda.com/
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This document provides guidance on performing a newborn examination. It begins by classifying newborns by gestational age and birth weight. It then describes how to assess vital signs, growth measurements, and the different body systems. Key parts of the examination are classified including the skin, head, eyes, chest, heart, abdomen, genitals and nervous system. Important reflexes are outlined to assess neurological development. The document emphasizes the importance of estimating gestational age and recognizing normal and abnormal findings during the newborn examination.
Surgical F1 Prep Talk - Dafydd Loughran
This document provides guidance and advice to a surgical trainee beginning their first day on call. It emphasizes being prepared with up-to-date patient information and bloodwork. It discusses appropriately evaluating and managing common acute surgical conditions like appendicitis and pancreatitis. Guidance is provided on consenting for procedures and communicating effectively with referral sources. The overall message is to focus on the basics of patient care and know when to escalate concerns, as the document aims to equip the trainee for typical issues that may arise on their first day on call.
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This document discusses the acute abdomen, including its characteristics, causes, clinical manifestations, assessment, and management. An acute abdomen is severe abdominal pain that requires urgent medical care or surgery. It can be caused by inflammatory conditions like appendicitis, perforations, obstructions, hemorrhage, or gallstones. Clinical assessment focuses on characteristics of the pain like onset, quality, and location. Management involves preoperative preparation, surgery, and postoperative care like monitoring vitals and wound healing. Complications include burst abdomen where the abdominal contents escape after surgery.
Abdominal Examination
This document provides an overview of abdominal examination techniques and findings. It discusses approaching gastrointestinal symptoms, performing a general physical exam, and specifically examining the abdomen through inspection, auscultation, percussion, and palpation. Key areas of the abdomen that can be examined include the liver, spleen, kidneys, gallbladder, and pancreas. Specific examination findings are outlined that may indicate various gastrointestinal conditions. The importance of thorough abdominal exams to evaluate symptoms and guide diagnosis is emphasized.
Gi emergenceis.pptx
Based on the limited information provided, additional history, physical exam findings, labs, and imaging are needed to determine the diagnosis. Features that would help differentiate some common acute abdominal conditions in a 15 year old male include:
- Location and radiation of pain (pancreatitis vs appendicitis)
- Fever, leukocytosis (appendicitis)
- Bilirubin, lipase/amylase (pancreatitis)
- Abdominal xray (pneumatosis intestinalis - malrotation)
- Rectal exam, CBC, imaging (intussusception)
- Scrotal exam (testicular torsion)
- Urinalysis (renal calculi)
- Blood
Small bowel obstruction cases - Julie Cornish
This document provides information on small bowel obstruction including:
- Common causes are adhesions and malignancy
- Initial workup includes bloodwork, abdominal x-ray, and consideration of CT scan
- For the 72 year old patient, differential diagnoses include adhesions from prior surgery or underlying Crohn's disease, with malignancy also a possibility given her age
- Conservative management is initially trialled but surgery may be needed for strangulation, perforation, or irreducible hernia
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The document discusses acute abdomen, defined as sudden severe abdominal pain of unclear cause lasting less than 24 hours. It often requires emergency diagnosis and treatment, with several potential surgical causes. A standardized approach involves taking a thorough history, conducting a physical exam, ordering investigations, and developing a treatment plan based on the final diagnosis. Common etiologies include inflammation, perforation, obstruction, hemorrhage, and medical conditions. The history and exam are important for determining the likely organ involved and ruling out serious issues. Investigations may include blood tests, ultrasound, CT scans, and x-rays to diagnose the specific cause and guide management.
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This document discusses pediatric foreign body ingestion. It notes that foreign body ingestion occurs most often accidentally in children between 6 months and 3 years old. Coins are the most common object ingested. It outlines the epidemiology, pathophysiology, clinical presentation, diagnostic imaging, and treatment approach depending on the object ingested and its location. Complications can include perforation, obstruction or fistula formation if sharp or multiple objects are ingested. Emergent evaluation is often needed for batteries, sharp or multiple objects lodged in the esophagus.
Adolescent gynecology ucaya
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The document provides guidance on performing a clinical examination of dogs. It outlines examining the dog's physical appearance, vital signs, and different body systems in a systematic manner from head to tail. Key steps include assessing the dog's demeanor, physical characteristics, medical history, and performing a hands-on examination of each region including eyes, ears, mouth, limbs, abdomen, heart, lungs, and rectum. Attention to detail, consistency in approach, and comparing both sides of the body are emphasized for a thorough physical exam.
Abdominal Pain
- Abdominal pain has many potential causes and determining the origin requires a detailed history, physical exam, and sometimes diagnostic tests.
- The location, character, timing and associated symptoms of the pain provide clues to its underlying mechanism, such as inflammation, obstruction, vascular or nerve issues.
- A thorough physical exam including inspection, abdominal palpation, and assessment of vital signs can help identify conditions like peritonitis but may not reveal the specific cause.
Common Urological Emergencies
1. Urology emergencies include testicular torsion, epididymo-orchitis, renal colic, urinary retention, and haematuria.
2. Testicular torsion requires urgent surgical exploration within 6 hours to salvage the testis. Epididymo-orchitis is usually treated with antibiotics but may require admission.
3. Renal colic from stones is initially managed conservatively but larger or obstructing stones may require shockwave lithotripsy or ureteroscopy. Urinary retention can often be managed with catheterization.
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Random ECGs 1
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Blood gases for nurses
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Rmo mil trauma
This document discusses principles of combat casualty care, including:
1. The goals of Tactical Combat Casualty Care (TCCC) are to save preventable deaths, prevent additional casualties, and complete the mission.
2. About 60% of combat deaths are from hemorrhage from extremity wounds, 33% from tension pneumothorax, and 6% from airway obstruction - all largely preventable causes if immediate lifesaving interventions are provided on the battlefield.
3. There are three categories of casualties - those who will live regardless, those who will die regardless, and those who could be saved by timely intervention to stop hemorrhage, relieve airway obstruction, or treat tension
Sumatra assist1
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This document summarizes guidelines for head CT scans in adults and children presenting to the emergency department with head trauma. It outlines criteria for when to CT scan based on factors like Glasgow Coma Scale score, loss of consciousness, age, mechanism of injury, vomiting, and neurological symptoms. It also provides recommendations for when to perform a repeat CT scan if symptoms worsen or change. The guidelines aim to identify clinically significant traumatic brain injuries requiring intervention while avoiding unnecessary radiation exposure from CT scans.
Ecg 101 with answers
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ECG 101
The ECG provides a window into the heart, lungs, electrolytes, body temperature and sometimes the brain. It is important to systematically interpret the ECG by examining features like the rate, rhythm, axes, QRS complex, ST segment, T waves and QTc interval. Interpreting ECGs helps identify conditions like myocardial ischemia, electrolyte imbalances and long QT syndrome. It is important to record the time and name on the ECG and order repeat ECGs as needed to monitor patients.
Anaphylaxis. Dr Tom Francis
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Surgical emergencies. Dr Rebecca Thomas
- 1. Surgical emergencies for the ED doctor Dr Rebecca Thomas Surgical Registrar Wanganui Hospital, March 2014
- 2. • A happy surgical registrar is a sleeping one • BUT…… – People get sick/injured 24 hours a day – We’re here if you need us
- 3. Overview • Guidelines on when to call • What to do first • What to say • Some more specific situations + tips
- 4. Guidelines • When do I call the surgical registrar? • If there is: – A hole in something – Something where it shouldn’t be – Something blocked – Something badly infected or inflamed – Significant concern from you or your colleagues about a patient
- 5. A hole in something • Ruptured aneurysm – Abdominal, iliac, [popliteal] – >60 years, abdominal pain, hypotension, pulsatile mass • Major bleeding – E.g. GI bleed – E.g. after trauma • Perforated viscus – Free air on CXR
- 6. Something where it shouldn’t be • An incarcerated hernia • Rectal prolapse • A foreign body • Innards on the outside
- 7. Something blocked • Bowel obstruction – Small or large – Volvulus • Ischaemic gut • Ischaemic limb
- 8. Something badly infected or inflamed • Pancreatitis • Appendicitis • Cholecystitis/cholangitis
- 9. Things not on the list • ENT things • Most patients with: – Minor complaints – Normal obs – Simple diagnoses/differentials – Problems that they could be discharged home with…..if it wasn’t 2am, dark outside, they have a sick cat, they’ve run out of milk, forgotten their slippers, and they can’t get a ride home. – E.g. biliary colic, small abscesses (if drainable in ED), gastroenteritis • Please give us a call in the morning – we can review these people just before ward round if necessary.
- 10. What to do first • History • Exam • Investigations • Differential diagnoses • Initial treatment
- 11. What to say • Who you are • Where you’re calling from • What you want – “I need you to come in now” – “I need some advice” – “I think this person needs to be admitted”
- 13. Hernias • Epigastric/umbilical/inguinal/femoral • Pain, incarceration, strangulation, obstruction
- 14. Pancreatitis • Commonly gallstones, alcohol • Amylase 3x/upper limit of normal + a good story • Don’t miss other pathology – AAA, perforated DU • CXR, LFTs, CRP, FBC, lactate, pO2 • Severity criteria – Ranson’s, modified Glasgow, APACHE II
- 15. Ischaemic gut • Often a difficult diagnosis to make – Elderly patient – Often in AF – Pain out of proportion to exam – Elevated lactate – Dilated bowel loops on AXR
- 16. Ischaemic limb • Pain, pallor, paraesthesia, pulselessness, perishingly cold • Pain pain pain pain pain + paralysis
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