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