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Acute referrals

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Acute referrals

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    1. Acute referrals Metale Biswas GPR

    2. Number of cases over 5 months

    3. Graph of number of cases from each speciality

    4. Number of acute referrals

    5. Significant acute referrals

    6. Cases - reflection 80y male PC 1/7 pleuritic chest pain, worse on movement, had been carrying shopping, dull ache the day before. PMH IHD, HTN, Ex-smoker. Probably MSK but?ACS. Ref MAU Angio, NSTEMI. 74y male PC 1/7 dull suprapubic pain, no urinary symptoms, unwell, vomiting, BO Normal. Abdo soft, testicular tenderness. MSU 1+ leuc, 4+ ket. Too unwell to be simple UTI. Refer urology. AXR, CT scan Gallstones for elective lap chole. 83y female Normally fit and well. Hyperthyroid, palpitations, SOB. Chest clear, I+II+O. ECG changes suggestive of ischaemia ? Old/new. Refer MAU kept in 1 night, nil acute. 31y female PC 5/7 Gradual onset SOB, no cough, no fever, not asthmatic. R sided chest discomfort. Not on OCP, non smoker. Chest - Reduced breath sounds R apex. ? Pneumothorax. Refer A&E CXR normal.

    7. Cases 42y female 1/7 headache, pain R occipital area, R eye blurred vision, N&V, vertigo. Raised cholesterol, ex-smoker. ?CVA. Refer MAU CT/scan and LP - Viral encephalitis. 35y female PC 2/7 Reduced sensation face, inco-ordination. Recent tooth infection, on metronidazole 200mg tds. O/e dysarthria, ataxia. ? S/e of metronidazole, can not rule out CVA. Refer MAU - Kept in one night s/e. 51 y female 1/7 neck pain, back pain, aches all over. Inco-ordination. Smokes 10/day, on HRT. Finger-nose and heel-to-toe difficult. ?Likely back pain, but unable to rule out CVA. A&E nad.

    8. Cases - reflection Age 7 PC 1/52 grumbling abdo pain, fever. Abdo soft, tender RIF, temp 37.8, tachycardia. ?Appendicitis. Refer Surgical team. Not appendicitis. 29y female G1P0+0, 9/40,PC PV bleeding, bright red. Abdo soft, non tender. ?Miscarriage. Refer EPU Scan no FHS Miscarriage. 36y female G3P1+1, 8/40, PC PV bleeding, dark brown. Abdo soft, non tender. ? Miscarriage. Refer EPU Scan no FHS - Miscarriage.

    9. Conclusion History and risk factors Unwell/well Safety netting Grey areas

    10. THANK YOU

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