Acute medicine and the older patient

This chapter discusses the older patient on the acute unit, including how to assess the older patient, assessing frailty, the comprehensive geriatric assessment (CGA), falls and collapse, fragility fractures, acute confusion syndrome (ACS), and palliative care and advance care planning.

Differential diagnosis of common presentations

This chapter explores the differential diagnosis of common presentations, including abdominal pain and distension, back pain, blackouts and collapse, breathlessness and dyspnoea, chest pain, confusion, constipation, cough, cutaneous manifestations of internal malignancy, diarrhoea, dysphagia, falls, fever, fits and seizures, haematemesis and melaena, haematuria, haemoptysis, headache, hemiparesis, hoarseness, itching and pruritus, joint pain and swelling, leg swelling, muscle weakness, nausea and vomiting, palpitations, tremor, unconsciousness and reduced consciousness, weak legs, and wheeze.

Dermatological emergencies

This chapter discusses dermatological emergencies, including cutaneous drug reactions, erythroderma, urticaria and angio-oedema, autoimmune bullous disease, eczema herpeticum, herpes zoster, generalized pustular psoriasis, and Stevens–Johnson syndrome and toxic epidermal necrolysis.

Neurological emergencies

This chapter discusses neurological emergencies, including coma, limb weakness, acute dizziness, acute loss of vision, painful red eye, acute bacterial meningitis, acute viral encephalitis, head injury, raised intracranial pressure (ICP), intracranial space-occupying lesion, haemorrhage (intracerebral, extradural, subdural, subarachnoid), status epilepticus (tonic–clonic), stroke, cerebral infarction syndromes, brainstem stroke, cerebellar stroke, transient ischaemic attacks (TIAs), confusional states and delirium, acute alcohol withdrawal, neuromuscular respiratory failure, myasthenic crises, spinal cord compression, Guillain–Barré syndrome (GBS), botulism, tetanus, the Glasgow Coma Scale (GCS), examination of brainstem function, and brain death.

Gastroenterological emergencies

This chapter describes gastroenterological emergencies, including acute upper gastrointestinal (GI) bleeding, peptic ulcer disease, erosive gastritis/oesophagitis, variceal haemorrhage, Mallory–Weiss tear, gastroenteritis (acute, bacterial, viral), Clostridium difficile, giardiasis, travellers’ diarrhoea, bloody diarrhoea, dysentery (bacterial, amoebic), inflammatory bowel disease (IBD), jaundice, hepatitis (viral, alcoholic, drug-induced, autoimmune), acholuric jaundice, sepsis, ischaemic hepatitis, obstructive jaundice, gallstone disease, acute cholecystitis, biliary obstruction, ascites, acute liver failure, ‘acute-on-chronic’ liver failure, hepatic encephalopathy, liver abscesses, and acute pancreatitis.

Respiratory emergencies

This chapter discusses respiratory emergencies, including pneumonia (acute, Mycoplasma, Legionella, viral, Chlamydia), psittacosis, acute asthma, acute severe asthma, mild to moderate asthmatic attacks, acute exacerbation of chronic obstructive pulmonary disease (COPD), respiratory failure, adult respiratory distress syndrome, pneumothorax (acute, tension), haemoptysis, pleural effusions, chronic massive effusion, empyema, and acute upper airway obstruction.

Diabetes and endocrine emergencies

This chapter describes diabetes and endocrine emergencies, including diabetic ketoacidosis (DKA; assessment, management, complications), hyperosmolar non-ketotic coma (HONK), hypoglycaemic coma, urgent surgery in patients with diabetes, diabetic foot complications, hyponatraemia, hypernatraemia, acute hypocalcaemia, hypercalcaemia, hypophosphataemia, Addisonian crisis, myxoedema coma, thyrotoxic crisis, pituitary apoplexy, hypopituitary coma, phaeochromocytomas, polyuria, malignant hyperthermia, and neuroleptic malignant syndrome.

Renal emergencies

This chapter discusses renal emergencies, including acute kidney injury (AKI), anuria, interstitial nephritis, rhabdomyolysis, hepatorenal syndrome, acute upper urinary tract infections, renal colic and renal stones, haematuria, renovascular disease, cholesterol embolism, and contrast nephropathy.

Practical procedures

This chapter discusses practical procedures in acute medicine, including arterial blood sampling, arterial line insertion, central line insertion, internal jugular vein cannulation, subclavian vein cannulation, ultrasound (US)-guided central venous catheterization, pulmonary artery catheterization, temporary cardiac pacing (ventricular pacing, atrial pacing, complications), pericardial aspiration, DC cardioversion, intra-aortic balloon counterpulsation, principles of respiratory support, mechanical ventilation, nasal ventilation, positive pressure ventilation, percutaneous cricothyrotomy, endotracheal intubation, aspiration of a pneumothorax, aspiration of a pleural effusion, insertion of a chest drain, ascitic tap (paracentesis), total paracentesis, insertion of a Sengstaken–Blakemore tube, percutaneous liver biopsy, transjugular liver biopsy, transjugular intrahepatic portosystemic shunt (TIPS), peritoneal dialysis, intermittent haemodialysis, plasmapheresis, renal biopsy, pH determination, joint aspiration, lumbar puncture, and needle-stick injuries.

Psychiatric emergencies

This chapter outlines psychiatric emergencies, including acute confusion (assessment, management), rapid tranquillization, acute alcohol withdrawal, neuroleptic malignant syndrome, dealing with violent patients, deliberate self-harm, the Mental Health Act, treating patients without their consent, the Mental Capacity Act, the law on consent and capacity, treating patients who do not wish to stay in hospital, detaining a patient in an emergency, and mentally ill patients in hospital.