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Reduction of dislocations

…patient with known instability and a low energy mechanism, and a neurovascularly threatened limb in which reduction cannot wait. A radiograph after reduction is always…

Wound suturing

…of function is a tendon injury that was sutured over without being found. Indications A traumatic wound that gapes and cannot be expected to heal…

Pleural aspiration and chest drain

…the basis of percussion and a chest radiograph alone belongs to an earlier era. The needle is inserted close to the upper border of the…

Casting and immobilisation

…over a joint. Pain relief and stabilisation for transfer in a suspected fracture. Clinical suspicion of a scaphoid fracture despite a normal radiograph. Contraindications An…

Abdominal Aortic Aneurysm: Screening and Surveillance

…Plain abdominal radiography has limited sensitivity. A calcified aneurysmal outline may be visible, but approximately one quarter of aneurysms are not calcified and therefore cannot…

Chest Pain in the Emergency Department: Diagnostic Pathways

…remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations…

Opioid therapy in severe pain

…depression, or untreated severe respiratory failure without the possibility of monitoring. Paralytic ileus and suspected obstructive ileus (an opioid can be given for the pain…

Opioids in acute pain: quick reference for dosing and conversion

…50 mg of oral morphine per day. Patches have no place in acute, unstable pain: the onset takes 12 to 24 hours and the offset…

Differential Diagnosis of Chest Pain: A Clinical Overview

…and a history of pain exacerbation with inspiration, along with a pleural friction rub, helps differentiate it from angina pectoris [5]. 5. Pulmonary Hypertension Pain…

Approach to patients with chest pain: differential diagnoses, management & ECG

…threatening causes of chest pain: Ischemic heart disease : stable angina pectoris, unstable angina pectoris, acute myocardial infarction (AMI). Note that unstable angina pectoris and acute…

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