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Summary of First Aid CCS cases

#residency/step3

Diagnosis (Location) /presentation/ workup /initial management treatment


counseling / follow-up

1. Migraine (Outpatient) /headache, photophobia, nausea/ CT head, labs anti-emetic,


analgesic, sumatriptan beta blockers, CCBs
2. Tension headache (Outpatient) /band-like headache, shoulder stiffness/ labs analgesic
relation exercises
3. Temporal arteritis (Ward) /temporal headache, jaw pain, blurry vision/ labs, ESR, CRP,
temporal artery biopsy prednisone follow ESR
4. Bacterial meningitis (Ward) /headache, fever/ LP, labs, cultures ceftriaxone,
vancomycin, dexamethasone
5. Hypertensive emergency (ICU) /headache, vomiting/ CT head, labs, EKG, monitors
labetalol, oxygen switch to PO when stable
6. Alzheimer’s (Outpatient) /Forgetfulness, trouble with ADLs/ labs, B12/folate, VDRL, CT
head Donepezil Patient/family counseling, advance directive
7. Normal pressure hydrocephalus (Ward) /Forgetfulness, unsteady gait, urinary
incontinence/ labs, LP, CT head, B12/folate Neurosurgery & neurology consults, VP
shunt Patient/family counseling, advance directive
8. Alcohol withdrawal (Ward) /anxious, tachycardic on hospital day 2/ labs, EKG, CT head
Thiamine, D5NS, Pyridoxine, Diazepam, replete lytes Naltrexone, social work, patient
counseling, smoking/alcohol cessation
9. Tonic-clonic seizure (Ward) /lost consciousness, jerking movements/ labs, U tox, CT/MRI
brain, EKG, EEG neurology consult Advise to not drive
10. Complete heart block (ICU) /fatigue, dizziness, syncope/ labs, trop, EKG, CXR, oxygen,
monitors cardiology consult, pacemaker, statin cardiac rehab, don’t drive, don’t
smoke, limit alcohol
11. Narcotic overdose (ICU) /Unresponsive, empty bottle/ naloxone, thiamine, D50, suction
airway, ABG, labs, NG tube gastric lavage, monitoring psychiatry consult, suicide
precautions
12. TCA intoxication (ICU) /respiratory distress, empty bottle/ intubate, labs, lactate, ketones,
U tox, EKG, CXR, CT head NG tube gastric lavage, activated charcoal, thiamine, D5NS,
lidocaine, magnesium sulfate monitoring UOP/BP, neuro checks, cardiology consult,
psychiatry consult
13. Transient ischemic attack (Ward) /slurred speech, facial droop, weakness now resolved/
labs, glucose, a1c, CT head aspirin, neurology consult, echo, carotid duplex, vascular