A 76-year-old woman presented to your ED four days ago with one day of vomiting, non-bloody diarrhoea and crampy left lower-quadrant pain. She reported fever and chills at home, with no sick contacts and no travel history. On presentation her temperature was 38 degrees C, HR 110, BP 118/76, RR 16 and SaO2 97% on room air. Documentation recorded mild LLQ tenderness without guarding or rebound and an empty rectum. WCC was 10.3 with 77% neutrophils, Hb 15 g/L, and EUC, lipase and LFTs were normal. At four hours her pain had improved, but temperature remained 38 degrees C and HR 100; she was discharged with a diagnosis of gastroenteritis.
Based on the documented clinical information, what makes this a high-risk discharge?
(Marked out of 2.0)
/ 2
Her discharge letter was copied from the clinical encounter and labs, labelled gastroenteritis, advised GP review within 48 hours and included a gastroenteritis fact sheet. What discharge information would you consider essential to include?
(Marked out of 5.0)
/ 5
She returned on day 2 febrile with ongoing vomiting and diarrhoea and was again discharged with oral rehydration advice. She returned on day 3 with an acute abdomen and CT showed a diverticular phlegmon with possible perforation. What processes would you identify to prevent recurrence of this encounter in your ED?
(Marked out of 4.0)
/ 4
Her son contacts the hospital and you are expected to manage his concerns. Outline how you would manage this.
(Marked out of 5.0)
/ 5
A registrar tells you he treated the patient both times and had consulted an emergency consultant who reassured him the plan was appropriate. How would you manage this situation?
(Marked out of 4.0)
/ 4
Total Score: 0 / 20
Percentage: 0%
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