Dizziness…the good and the ugly…

The differential diagnosis of vertigo can be broken into peripheral and central causes. It is imperative the Emergency Physician consider central causes of vertigo. Signs/ Symptoms Differentiating Peripheral and Central Vertigo   Peripheral Central Onset Sudden or Insidious Sudden Severity of Vertigo Intense Spinning Ill-defined, may be severe or less intense Prodromal Dizziness Occurs in […]

Oxygen therapy for acutely ill medical patients: a clinical practice guideline

What you need to know It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases mortality for medical patients in the hospital For patients receiving oxygen therapy, aim for peripheral capillary oxygen […]

TIA (Transient Ischaemic Attack)

TIA is defined as a brief episode of neurologic dysfunction with no permanent infarction. Head CT noncontrast is not reliable for acute ischemia, but it can find alternative conditions necessitating management. MRI with DWI displays greater diagnostic ability. Risk scores that predict future stroke are not reliable when used alone. Patients are typically admitted for […]

Acute Visual Loss in the ED

History including specific eye involvement, sudden vs. chronic loss, pain, redness and discharge, trauma, other symptoms, and medication use are vital. Physicians should be comfortable completing an appropriate history and physical examination including general inspection, visual acuity, pupils, EOMs, visual fields, fluorescein, lids, IOP, slit lamp, and US. Emergent consultation is required for acute angle […]

TIA

[CLICK IMAGE TO PLAY VIDEOS] Cornerstones of treatment for TIA revolve around reducing the risk of future events with blood pressure control, lipid control, and antiplatelet agents. Blood pressure should be maintained at 140/90 with a thiazide diuretic and/or an ACE inhibitor. Statins should be given to keep LDL of under 100mg/dL or 70mg/dL in […]

Emergency Medicine Kenya Foundation