(BQ) Part 1 book 100 Cases in emergency medicine and critical care has contents: Respiratory distress in a tracheostomy patient, head-on motor vehicle collision, a productive cough,.... and other contents.
100 Cases in Emergency Medicine and Critical Care http://taylorandfrancis.com 100 Cases in Emergency Medicine and Critical Care Eamon Shamil MBBS MRes MRCS DOHNS, AFHEA Specialist Registrar in ENT – Head & Neck Surgery Guy’s and St Thomas’ NHS Foundation Trust, London, UK Praful Ravi MA MB BChir MRCP Resident in Internal Medicine, Mayo Clinic, Rochester, MN, USA Dipak Mistry MBBS BSc DTM&H FRCEM Consultant in Emergency Medicine, University College London Hospital NHS Foundation Trust, London, UK 100 Cases Series Editor: Janice Rymer Professor of Obstetrics & Gynaecology and Dean of Student Affairs, King’s College London School of Medicine, London, UK Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works Printed on acid-free paper International Standard Book Number-13: 978-1-139-03547-8 (Paperback) International Standard Book Number-13: 978-1-138-57253-9 (Hardback) This book contains information obtained from authentic and highly regarded sources While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and not necessarily reflect the views/opinions of the publishers The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint Except as permitted under U.S Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers For permission to photocopy or use material electronically from this work, please access www.copyright.com (http:// www.copyright.com/) or contact the Copyright Clearance Center, Inc (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400 CCC is a not-for-profit organization that provides licenses and registration for a variety of users For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com To Mum, Dad, Dania, and Adam for their unconditional love To Mohsan, Shah, and Praful for their endless support And to my patients and teachers, who have drawn me closer to humanity Eamon Shamil To my parents, patients and teachers Praful Ravi To my wife, Snehal, for her endless support Dipak Mistry http://taylorandfrancis.com CONTENTS Contributors Introduction xi xiii Critical Care Case 1: Respiratory distress in a tracheostomy patient 1 Case 2: Nutrition 5 Case 3: Shortness of breath and painful swallowing 9 Case 4: Collapse while hiking 13 Case 5: Fever, headache and a rash 17 Case 6: Nausea and vomiting in a diabetic 19 Case 7: Stung by a bee 23 Case 8: A bad chest infection 27 Case 9: Head-on motor vehicle collision 31 Case 10: Intravenous fluid resuscitation 35 Case 11: Found unconscious in a house fire 37 Case 12: Painful, spreading rash 41 Case 13: Submersion 45 Case 14: Crushing central chest pain 49 Internal Medicine Case 15: Case 16: Case 17: Case 18: Case 19: Case 20: Case 21: Case 22: Case 23: Case 24: Case 25: Case 26: Case 27: Case 28: Case 29: Case 30: Case 31: Case 32: Short of breath and tight in the chest 53 A productive cough 57 A collapse at work 61 Dysuria and weakness 63 Leg swelling, shortness of breath and weight gain 67 Chest pain in a patient with sickle cell anaemia 71 Fever, rash and weakness 75 Rectal bleeding with a high INR 77 Back pain, weakness and unsteadiness 81 Feeling unwell while on chemotherapy 83 Productive cough and shortness of breath 87 Vomiting, abdominal pain and feeling faint 89 Seizure and urinary incontinence 91 Chest pain in a young woman 95 Faint in an elderly woman 99 An abnormal ECG 103 Fever in a returning traveller 107 Loose stool in the returned traveller 111 vii Contents Mental Health and Overdose Case 33: Case 34: Case 35: Case 36: Unconscious John Doe 115 An unresponsive teenager 119 Deteriorating overdose 125 Attempted suicide 129 Neurology and Neurosurgery Case 37: Case 38: Case 39: Case 40: Case 41: Case 42: Case 43: Back pain at the gym 133 Passed out during boxing 137 Headache, vomiting and confusion 141 Motor vehicle accident 143 Slurred speech and weakness 147 A sudden fall while cooking 151 Neck pain after a road traffic accident 153 Trauma and Orthopaedics Case 44: My back hurts 155 Case 45: My shoulder popped out 159 Case 46: Fall on the bus 163 Case 47: Motorbike RTC 165 Case 48: Fall onto outstretched hand (FOOSH) 167 Case 49: Painful hand after a night out 171 Case 50: Cat bite 173 Case 51: Pelvic injury in a motorcycle accident 177 Case 52: Unable to stand after a fall 181 Case 53: Twisted my knee skiing 185 Case 54: Fall in a shop 187 Case 55: I hurt my ankle on the dance floor 191 Case 56: Fall whilst walking the dog 195 General Surgery and Urology Case 57: Case 58: Case 59: Case 60: Case 61: Case 62: Case 63: Case 64: viii Upper abdominal pain 199 Gripping abdominal pain and vomiting 203 My ribs hurt 207 Severe epigastric pain 211 Left iliac fossa pain with fever 213 Acute severe leg pain 217 Abdominal pain and nausea 219 Epigastric pain and nausea 223 Contents Case 65: Case 66: Case 67: A 68-year-old man with loin to groin pain 227 Right flank pain moving to the groin 231 Testicular pain after playing football 235 ENT, Ophthalmology and Maxillofacial Surgery Case 68: Case 69: Case 70: Case 71: Case 72: Case 73: Case 74: Case 75: Case 76: Case 77: Recurrent nosebleeds in a child 237 Worsening ear pain 241 Chicken bone impaction 243 Ear pain with discharge and facial weakness 245 Post-tonsillectomy bleed 247 A swollen eyelid 249 Red eye and photosensitivity 253 Painful red eye 257 Visual loss with orbital trauma 261 Difficulty opening the mouth 265 Paediatrics Case 78: Case 79: Case 80: Case 81: Case 82: Case 83: Case 84: Case 85: Case 86: Case 87: Cough and difficulty breathing in an infant 269 A child with stridor and a barking cough 271 A child with fever of unknown origin 273 My son has the ‘runs’ 277 A child with lower abdominal pain 281 A child acutely short of breath 283 A child with difficulty feeding 287 A child with head injury 291 The child with prolonged cough and vomiting 293 A child with a prolonged fit 297 Obstetrics and Gynaecology Case 88: Case 89: Case 90: Case 91: Case 92: Case 93: Case 94: Case 95: Case 96: Case 97: Vomiting in pregnancy 301 Abdominal pain in early pregnancy 305 Bleeding in early pregnancy 309 Pelvic pain 313 Abdominal pain and vaginal discharge 317 Vulval swelling 321 Fertility associated problems 325 Headache in pregnancy 329 Breathlessness in pregnancy 333 Postpartum palpitations 337 ix .. .10 0 Cases in Emergency Medicine and Critical Care http://taylorandfrancis.com 10 0 Cases in Emergency Medicine and Critical Care Eamon Shamil MBBS MRes MRCS DOHNS, AFHEA Specialist Registrar in. .. unconscious in a house fire 37 Case 12 : Painful, spreading rash 41 Case 13 : Submersion 45 Case 14 : Crushing central chest pain 49 Internal Medicine Case 15 : Case 16 : Case 17 : Case 18 : Case 19 : Case... Case 97: Vomiting in pregnancy 3 01 Abdominal pain in early pregnancy 305 Bleeding in early pregnancy 309 Pelvic pain 313 Abdominal pain and vaginal discharge 317 Vulval swelling 3 21 Fertility associated