Middle twist

A 74-year-old man on the orthopaedic ward is found drowsy six hours after his first dose of slow-release oxycodone for a fractured neck of femur. He rouses brie…

Acute Care · Pre-internship · middle twist

A 17-year-old girl weighing 55 kg says she swallowed 45 tablets of immediate-release paracetamol 500 mg about ten hours ago after an argument with her partner.…

Acute Care · Pre-internship · middle twist

A 70 kg man has a 12 cm laceration across the extensor surface of his right forearm from a falling pane of glass. Tendon function through the full range of move…

Acute Care · Pre-internship · middle twist

A 7-year-old girl fell from a scooter onto her outstretched hand yesterday. Her wrist is swollen and tender about 2 cm proximal to the wrist crease, she is usin…

Acute Care · Pre-internship · middle twist

A 34-year-old man is brought in after a petrol fire in a shed. The skin over the whole front of his chest and abdomen is blistered, moist and painful. His right…

Acute Care · Clinical rotations · middle twist

A 9-year-old girl is brought to a Western Australian emergency department by her mother with three weeks of intermittent abdominal pain. While her mother is out…

Acute Care · Pre-internship · middle twist

A 58-year-old man is treated in the emergency department for a Colles fracture sustained tripping over a gutter. He smokes 25 cigarettes a day and lights the fi…

Acute Care · Clinical rotations · middle twist

A 24-year-old woman is brought in by ambulance after being found unrousable at home. She had swallowed six of her flatmate's morphine tablets, which he takes tw…

Acute Care · Pre-internship · middle twist

A 41-year-old bricklayer attends the emergency department after cutting his forearm on a broken glass door at home. The wound is cleaned and sutured. On routine…

Acute Care · Clinical rotations · middle twist

A 23-year-old woman is medically cleared six hours after taking 20 of her flatmate's quetiapine tablets at the end of a relationship. She says she regrets it, i…

Acute Care · Pre-internship · middle twist

A 74-year-old woman is being discharged from the emergency department after a fall at home with an undisplaced pubic ramus fracture on radiography. She can weig…

Acute Care · Pre-internship · middle twist

A 6-year-old boy fell from a trampoline five hours ago onto grass. He cried immediately and did not lose consciousness. He vomited once at the scene and not sin…

Acute Care · Clinical rotations · middle twist

The mother of a 5-year-old girl admitted to a Perth public hospital with gastroenteritis tells the bedside nurse that her daughter is going flat and is not hers…

Acute Care · Pre-internship · middle twist

A 58-year-old man walks into a Perth emergency department at 1900 hours saying he has had heavy central chest pain radiating to his jaw for the past 40 minutes.…

Acute Care · Clinical rotations · middle twist

A 74-year-old man collapses in a shopping centre and is brought to the emergency department in cardiac arrest. Resuscitation is unsuccessful and he is declared…

Acute Care · Pre-internship · middle twist

An intern covering a Perth hospital's wards and its residential aged care liaison service is asked about five deaths in one afternoon. All five are Western Aust…

Acute Care · Clinical rotations · middle twist

A 58-year-old man dies in the resuscitation bay after an out-of-hospital cardiac arrest. His wife and adult daughter have been waiting in the relatives room wit…

Acute Care · Pre-internship · middle twist

A 61-year-old woman with metastatic pancreatic cancer is in the emergency department short-stay unit with vomiting. She already knows her disease is incurable.…

Acute Care · Clinical rotations · middle twist

An 82-year-old woman with advanced dementia is admitted to a Perth hospital with a fractured neck of femur. She cannot repeat back or weigh up any part of the d…

Acute Care · Pre-internship · middle twist

A 34-year-old man is brought to a Perth emergency department with a stab wound to the thigh. He is alert, gives a clear account of the assault, and knows the da…

Acute Care · Pre-internship · middle twist