OBSERVATION Ward

OBSERVATION Ward

Emergency department (ED) patients frequently require services beyond their initial ED care to determine the need for inpatient admission. Observation Ward ( OR ) , also known as Clinical Decision Unit ( CDU ) or Clinical Observation Unit ( COU ) are increasingly becoming an important component of the modern ED. 

Observation is by definition the use of appropriate monitoring, diagnostic testing, therapy, and assessment of patient symptoms, signs, laboratory tests, and response to therapy for the purpose of determining whether a patient will require further treatment as an inpatient or can be discharged form the hospital setting.

To promote quality of care and patient safety for ED observation patients, the American College of Emergency Physicians (ACEP) supports the following principles:

Snake Envenomation COURSE

Snake Envenomation Course

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Cranial Nerve Examination

Cranial Nerve Examination

Cranial nerves are those nerves which arise from the brain and brain stem rather than the spinal cord. Nerves arising from the spinal cord are the peripheral nerves. There are 12 pairs of cranial nerves and these pairs of nerves passage through foramina in the skull, either individually or in groups. Cranial nerves are traditionally referred to by Roman numerals and these numerals begin cranially and run caudally.

Approach to AGGRESIVE Patients

Approach to AGGRESIVE Patients

Healthcare workers, especially staff in emergency departments, are likely to encounter aggression and violence every day. These problems can occur in combination. It is important that a diagnosis is made, to assess and manage these patients properly, with-out biases, and with the same thoroughness that you assess every patient with. Practice design and policies as well as staff training can help to reduce the risk of violence.

Aggression and violence may be a manifestation of underlying psychiatric disorders. These include drug psychosis, delusional states, mania and personality disorder. Some patients try to use aggression as means of achieving a particular goal, such as being seen earlier or obtaining drugs.

CPR 2015 Guidelines

CPR 2015 Guidelines

The European Resuscitation Council Guidelines for Resuscitation 2015 released today , provide specific instructions for how resuscitation should be practiced and take into account ease of teaching and learning, as well as the science. 

They were developed by Europeans and have been specifically written with European practice in mind.

CPR 2015 Guidelines                    Download
CPR 2015 Guidelines COSTR        Download 

CPR 2015 Posters                        Download

CPR 2015 Summary Of Changes   Download

Source : http://www.cprguidelines.eu

NUMB Chin Syndrome

NUMB Chin Syndrome

Introduction

Numb chin syndrome ( NCS ) also called mental neuropathy , is a rare sensory neuropathy of the mental nerve characterized by numbness, hypoesthesia, paraesthesia, and very rarely pain.

Because the inferior alveolar nerve has no motor fibers, NCS is a purely sensory neuropathy. Common symptoms include numbness over the lower lip, chin, and gingival mucosa; pain is not usually a feature of NCS. 

Dental causes, especially iatrogenic ones, maxillofacial trauma, or malignant neoplasm are etiologic factors for this rare syndrome. Compression of the mandibular division of the trigeminal nerve at the base of the skull by a tumor mass or leptomeningeal invasion may also cause NCS.

FLOOD , Are We Prepared?

FLOOD , Are We Prepared?

Malaysia is prone to annual flooding while experiencing a major flooding event at least once every five years where multiple states are affected. Towards the end of the year, northeast monsoons cause massive heavy downpours of rain, particularly in the eastern states. Such is the frequency of floods that traditional stilt houses are often constructed along coastlines and rivers.

10.1% of the country's total area with 5.67 millions people living in flood prone areas.

Due to its relative regularity, flood mitigation, forecasting and warning system efforts have been undertaken by various agencies to minimise impacts brought forth by floods. Such an event scrutinises Malaysia’s ability to respond to floods in the area of readiness, relief, and rebuilding.

HYPOGLYCAEMIA D10% Dilemma

HYPOGLYCAEMIA D10% Dilemma

Dextrose 50% (D50%) has its own long track record as the "Wonder Drug" of hypoglycaemia in Emergency Department but recent update on Dextrose 10% ( D10% ) usage for hypoglycaemia is quite intresting to discuss.

Drawbacks of D50

1. Rebound hypoglycemia

After administration of D50 there is an excess amount of glucose available, leading to increased uptake and utilization by the tissues, which suppresses both gluconeogenesis and glycogenolysis. Without continued administration of dextrose-containing fluids, this may result in rebound hypoglycemia. Moreover, with the loss of IV access, a busy ED, and a subsequent fingerstick in the 200’s, the decision to initiate such fluids may be overlooked or delayed, thereby facilitating this risk of rebound hypoglycemia.

Field TRIAGE

Field TRIAGE

TRIAGE , originated from French word trier which means “to sort” , to assign treatment priorities with limited resources. Attention must be given to the most salvageable with most urgent condition.

Slogan : 

Do The Greatest Good For The Greatest Number

To Do The Most For The Most


Field triage is important to understand due to increasing cases of disaster , limited personnel and resources. Triage practice  - divided into traditional and disaster