It is one of the most reflexive co-prescriptions in hospital medicine: a patient is started on corticosteroids, and almost in the same pen-stroke, a proton pump inhibitor (PPI) is added “for gastric protection.” It feels prudent, harmless, and defensible. But…
Distinguishing between Bell’s palsy and a stroke is critical because, while Bell’s palsy is generally non-emergency nerve inflammation, a stroke is a life-threatening medical emergency. The most important physical differentiator is how much of the face is involved. The “Forehead…
Clinical Pharmacology & Microbiology Mechanism of Action Vancomycin is a tricyclic glycopeptide that inhibits bacterial cell wall synthesis by binding with high affinity to the D-alanyl-D-alanine terminus of cell wall precursor units. This binding sterically hinders the transglycosylase and transpeptidase…
Hyperkalemia (a serum potassium K+ > 5.5 mmol/L) is one of the most common and dangerous electrolyte emergencies. It is a “silent killer” that can progress from an asymptomatic lab finding to a fatal arrhythmia within minutes. Effective management requires…
In any hospital, the risk of a patient’s condition suddenly deteriorating is a constant clinical reality. Studies show that patients who eventually require admission to an Intensive Treatment Unit (ITU) often display significant derangements in their vital signs—such as oxygen…
Chest drain insertion, or tube thoracostomy, is a fundamental procedure for managing conditions involving the pleural space. It involves placing a tube through the chest wall to drain air, fluid (blood, pus, or effusion), or to aid lung re-expansion after…
In the emergency department, few procedures are as common as peripheral intravenous (IV) cannulation. It’s often seen as a “basic” task, handed off to the most junior member of the team. But this is a fundamental skill and “subtleties in…
Anaphylaxis is the quintessential medical emergency. It’s sudden, terrifying for the patient and demands rapid, decisive action. As an emergency physician, you are the critical link between a catastrophic outcome and a full recovery. While the core treatment—intramuscular (IM) adrenaline—is…
Asthma can be a manageable condition, but confidential enquiries into hundreds of asthma deaths in the UK have revealed sobering lessons. These reports, which informed the BTS/SIGN (British Thoracic Society/Scottish Intercollegiate Guidelines Network) guidelines, show that most fatalities are preventable…
Hypoglycemia, defined as a dangerously low blood glucose level, is the most common limiting factor in the glycemic management of diabetes. In the acute setting, particularly the Emergency Department (ED), prompt and correct management is critical as severe hypoglycemia (Level…