Que - 15 y.o male bought in to ED via ambulance after having sudden collapse while playing sports. He is feeling fine and doesn't remember what happen. Examination is unremarkalbe. What is the best management step you will do?
Ans -
1 - Discharge him home
2 - Do CBE and electrolytes
3 - Do ECG, CBE and electrolytes
4 - Do ECG, CBE, electrolytes and discussed the case with Cardiology prior to discharge
5 - Arrange CT scan of brain and abdomen
Ans -
1 - Discharge him home
2 - Do CBE and electrolytes
3 - Do ECG, CBE and electrolytes
4 - Do ECG, CBE, electrolytes and discussed the case with Cardiology prior to discharge
5 - Arrange CT scan of brain and abdomen
Is it 5. CT...???
ReplyDeleteThe correct answer would be 4 to look for arrythmia and consideration of holter and echo. Intracranial pathology is unlikely and exposure to radiation is unnecessary at this stage.
ReplyDeleteif checking for arrhythmia, why is cbe needed?
ReplyDeleteNo it is not necessary. There is no option without CBE which is correct. I would still think CBE should come in, as anaemia and infection can be trigger for arrhythmia. CBE is also part of initial blood as in Australia - ED, we send CBE and MBA20 for initial blood - This is just a practical thing.
ReplyDeletethanks sachin- good to know that.
ReplyDelete