Tamingthesru
Feeling "Dizzy"
This month we have the pleasure of discussing the chief complaint of “dizziness” with Dr. William Knight. In the attached podcast much of our discussion regarding this symptom focuses on stroke as a cause of this complaint. Even so, it is important to remember that not all patients who present to the emergency department with dizziness are experiencing a stroke. Quite the opposite; the majority of patients seeking care for feeling “dizzy” or “lightheaded” or “imbalanced” will have a cause other than restriction of blood flow to, or bleeding into, the posterior fossa.
The Agitated Patient
I don’t know if this has happened to you yet. It happened to me on my first shift as an intern. I hadn’t laid hand on a stethoscope in months. I had just unloaded the cardboard boxes from my rental truck into my new place. As I was settling in to my first few patient encounters one of our nurses approached me to say that a patient had been brought into our area that was extremely agitated. I looked up to see a man being held down by multiple police officers, thrashing and swearing.
“What can I give him?” She said.
“How about a hug?” I replied.
The Approach to the Undifferentiated Patient
Welcome to Bread and Butter Emergency Medicine; a back to basics, chief-complaint-based podcast series where we get a chance to pick the brains of various faculty members and residents regarding their plan of attack for a particular presenting symptom. Imagine your first shift in the emergency department (or think back on it if you’ve been doing this for a while); a man or woman with the label of “chest pain” or “headache” or “medication refill” is sat down in front of you, staring at you through the glass of your workstation.