Sunday, April 25, 2010
ACCIDENTS AND EMERGENCIES 101
The accident and emergency ward is the most important ward in the hospital. "first bus-stop when a patient arrives"
A 27 year old man was rushed into the A&E, he was involved in a RTA (road traffic accident), patient presented with bleeding to the left ear and a swollen left thigh and was semi-conscious.
Discuss the management of this patient.
This is an emergency and the patient should be attended to immediately.
1.The basic ABC's (Airways, breathing and circulation)
2. A Glasgow coma scale should be performed immediately.
3. Check the blood pressure and control bleeding.
4. Set up an intravenous line infusing normal saline to avoid shock.
5. Set up another vein and take blood for baseline investigations ( full blood count, blood grouping and cross matching, packed cell volume, electrolyte/urea/creatinine, RVS (retro-viral screening) and urinalysis)
6. Insert a urinary catheter if the patient is unconscious
7. Specific investigations should be carried out. ( an X-ray of the head and neck(CT scan preferably), AP and Lateral x-ray of the left femur, x-ray of the hip joint)
8. Send an emergency consult to the surgical team.
9. Examine the 2 ears, examining from the right to the left.
10. Send an emergency consult to the ENT team (Ear, Nose and throat specialists)
11.When the patient is stabilized, take a good history from relatives or from him, Past medical history, drug history and allergies.
Thats all for now folks............
To be continued...
errrr, any questions????
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