Signs and symptoms | Possible cause |
History suggesting head injury, bruising, decreased level of consciousness (coma scale)
One-sided weakness, speech difficulties
Ataxia (unsteadiness) | Head injury
Intracranial bleed (stroke) — urgent medical consult |
Problem swallowing
Food/fluids stuck in gullet | Uncoordinated swallowing, oesophageal blockage — medical consult |
Blood in vomit | Oesophageal tear, oesophageal varices (complicating cirrhosis), penetrating peptic/ gastric ulcer — medical consult |
Right lower abdominal pain, mild fever | Appendicitis |
Severe abdominal pain, marked tenderness, rebound or percussion tenderness, fever | Peritonitis — medical consult |
Severe upper abdominal pain that may radiate to back, epigastric tenderness | Pancreatitis — medical consult |
Green bile, crampy abdominal pain, swollen belly, diarrhoea then no faeces | Bowel obstruction |
Undigested food in vomit | High abdominal obstruction — medical consult |
Abdominal cramps, diarrhoea
Abrupt onset within 4 hours of eating and others who ate the same meal affected | Gastroenteritis, food poisoning — medical consult
*If child with vomiting and significant pain, unlikely to be gastroenteritis — medical consult |
| Child with sweet odour of acetone and rapid breathing +/- abdominal pain (high BGL,
elevated ketones, low pH and HCO3 on VBG) | Diabetes ketoacidosis |
Small child with unusual odour, agitated or sedated, rapid or slow heart rate, high
temperature, flushed, dilated or constricted pupils, ataxia | Toxic Ingestion — medical consult |
History of medicine consumption | Prescription medicines (eg morphine) — medical consult |
History of drug use
Alcohol — smell on breath, reduced inhibition, slurred speech, reduced motor control,
bloodshot eyes
Cannabis — gets relief from hot shower | Drugs Alcohol Cannabis |
Pregnancy — usually first trimester | Morning sickness |
Feeling of motion — room spinning, sweating, abnormal eye movements | Vertigo — also a symptom, need to determine cause — medical consult |