Beach party SAQ by Tegan Lynam

 

This SAQ is worth 15 marks

You are in an emergency department in north Queensland, when you receive a notification from the ambulance service that they are en route with a 31yo man after being pulled from the surf with an altered level of consciousness.

Question 1.
1. List 4 differential diagnoses for this man’s presentation (4 marks)

1.
2.
3.
4.



Question 2.
He arrives to your emergency department with the following observations

HR 160bpm
BP 80/40
RR 10bpm
SpO2 89% 6L HM
GCS 11 E4V2M5
- agitated and combative and appears in pain

He has had no treatment by the paramedics or on scene due to his behaviour

A photo is attached

Describe the picture


(1 mark)

View attached:   Attachment 1



Question 3.
What is your diagnosis?

(2 marks)



Question 4.
What is your initial treatment for this?


(3 marks)

1.
2.
3.



Question 5.
What are 3 of the indications for antivenom?

(3 marks)

1.
2.
3.



Question 6.
In what two marine envenomation circumstances in magnesium indicated?


(2 marks)

1.
2.



 

This SAQ is worth 15 marks

You are in an emergency department in north Queensland, when you receive a notification from the ambulance service that they are en route with a 31yo man after being pulled from the surf with an altered level of consciousness.

Question 1.
1. List 4 differential diagnoses for this man’s presentation (4 marks)

Trauma – head injury, pneumothorax
Marine envenomation – box jellyfish, Irukandji, sea snake
Toxicology- drug intoxication or withdrawal,
Drowning
Medical problem – asthma, SAH, seizure
Anaphylaxis


Question 2.
He arrives to your emergency department with the following observations

HR 160bpm
BP 80/40
RR 10bpm
SpO2 89% 6L HM
GCS 11 E4V2M5
- agitated and combative and appears in pain

He has had no treatment by the paramedics or on scene due to his behaviour

A photo is attached

Describe the picture


(1 mark)

View attached:   Attachment 1

Extensive wheal whip like pattern involving the whole of the visualised leg

Question 3.
What is your diagnosis?

(2 marks)

Box jellyfish (Cironex fleckeri) stings with systemic envenomation

Question 4.
What is your initial treatment for this?


(3 marks)

Apply vinegar liberally and remove tentacles
IV opiates for pain
Antivenom

Question 5.
What are 3 of the indications for antivenom?

(3 marks)

-unconscious
-cardiorespiratory arrest
-hypotension
-dysrhythmia
-hypoventilation
-difficulty with breathing, swallowing or speaking
-severe pain
-possibility of significant skin scarring


Question 6.
In what two marine envenomation circumstances in magnesium indicated?


(2 marks)

As an adjunct to antivenom in severe box jellyfish envenomation
Irukandji syndrome


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environmental   antivenom