Rapid Emergency and Unscheduled Care

List of Contributors x Preface xi Acknowledgements xii List of Abbreviations xiii Cardiovascular Abdominal aortic aneurysm 3 Acute coronary syndrome 4 Anaphylaxis 5 Aortic dissection (thoracic) 8 Atrial fibrillation 9 Bradycardia 10 Deep vein thrombosis 12 Heart failure 13 Hypertension 14 Ischaemic lower limb 15 Myocarditis 16 Pericarditis 17 Shock 18 Tachycardia 19 Ear, nose and throat (ENT) Acute sore throat 23 Auricular haematoma 24 Epiglottitis 24 Epistaxis 25 Foreign bodies 26 Glandular fever 27 Mumps 28 Nose injury 28 Otitis externa (acute) 29 Otitis media (acute) 29 Peritonsillar abscess (quinsy) 30 Endocrine Diabetes mellitus: Type 1 35 Diabetes mellitus: Type 2 36 Diabetic ketoacidosis (DKA) 36 Hyperkalaemia 38 Hypokalaemia 38 Gastroenterology Abdominal trauma 43 Appendicitis 44 Biliary colic 45 Cholecystitis (acute) 45 Crohn’s disease 46 Diverticulitis 47 Gastroenteritis 48 Gastrointestinal bleeding (upper) 49 Gastrointestinal bleeding (lower) 52 Gastrointestinal perforation 52 Gastro‐oesophageal reflux disease (GORD) 53 Irritable bowel syndrome (IBS) 54 Pancreatitis (acute) 55 Pancreatitis (chronic) 56 Paralytic ileus 57 Peptic ulcer disease 57 Peritonitis 58 Small bowel obstruction 59 Ulcerative colitis 60 Genitourinary Acute kidney injury (AKI) 65 Chronic renal failure 66 Renal colic 67 Testicular torsion 67 Urinary tract infection (UTI) 68 Infections sepsis and infectious diseases Malaria 73 Sepsis 74 Septic arthritis 75 Typhoid 76 Mental health emergencies Mental health overview 81 Characteristics of different psychiatric illnesses 82 Acute confusion (delirium) 83 Acute psychosis 84 Acute anxiety and panic attacks 85 Deliberate self‐harm 86 Mental Health Act overview 87 Musculoskeletal Achilles tendon injuries 91 Ankle injuries 92 Back pain (acute) 93 Calcanium fractures 95 Compartment syndrome 95 Elbow injuries 96 Femoral injuries 99 Foot injuries 101 Gastrocnemius muscle tears 103 Hand injuries 104 Knee injuries 107 Neck pain: Traumatic neck sprain 110 Pelvic fractures 111 Plantar fasciitis 111 Pulled elbow 112 Shoulder and clavicle injuries 113 Tibial/fibular injuries 114 Traumatic amputation 116 Upper limb injuries 116 Volar plate injuries 118 Wrist injuries 118 Neurology Bell’s palsy 123 Encephalitis 124 Epilepsy 125 Giant cell arteritis 126 Guillain–Barré syndrome 127 Meningitis 128 Migraine 129 Minor head injuries 130 Status epilepticus 131 Stroke (cerebrovascular event) 132 Subarachnoid haemorrhage 133 Subdural haemorrhage 134 Obstetrics and gynaecology Eclampsia 139 Ectopic pregnancy 139 Hyperemesis gravidarum 141 Miscarriage 141 Pre‐eclampsia 142 Vaginal bleeding (late pregnancy) 143 Ophthalmology Acute angle‐closure glaucoma 147 Anterior uveitis 147 Blunt trauma 148 Chemical injury 149 Conjunctivitis 150 Corneal injury 150 Foreign bodies 151 Loss of vision 152 Subconjuctival haemorrhage 153 Superglue injuries 153 UV radiation injuries 154 Overdose and poisoning Alcohol misuse and intoxication 157 Carbon monoxide poisoning 158 Drug misuse 158 Paracetamol overdose 159 Poisoning 160 Respiratory Asthma 165 Chest sepsis (including pneumonia) 166 Chest wall injury 167 Chronic obstructive pulmonary disease (COPD) 168 Croup (acute laryngotracheobronchitis) 170 Cystic fibrosis 171 Flail chest 172 Haemothorax 173 Lung cancer 173 Open chest wound: Medical emergency 174 Pulmonary embolism 174 Pneumothorax (simple) 175 Tension pneumothorax: Medical emergency 176 Skin Abscesses 179 Animal bites 179 Burn to skin 180 Cellulitis 182 Dermatophyte infection of the skin: Body and groin 183 Human bite 184 Impetigo 185 Necrotising fasciitis 185 Scabies 186 Varicella infection 187 The electrocardiogram Electrocardiograph (ECG) 191 Atrial fibrillation 191 Atrial flutter 191 Asystole 192 First‐degree heart block 192 Normal sinus rhythm 192 Pulseless electrical activity (PEA) 192 Second‐degree heart block: Mobitz type 1 (Wenckebach) 193 Second‐degree heart block: Mobitz type 2 193 Sinus bradycardia 193 Sinus tachycardia 194 Supraventricular tachycardia (SVT) 194 Third‐degree heart block: Complete heart block 194 Torsade de pointes 194 Ventricular fibrillation 195 Ventricular standstill 195 Ventricular tachycardia (VT) 195 Index 197