Emergency Medicine

Question 1

Box jellyfish first aid vs. bluebottle jellyfish first aid

Answer 1

Box:
-immediately remove tentacles (use seawater)
-liberal vinegar over sting sites
-cold pack/ice massage for small stings
-analgesia
-Antivenom if major stings

Bluebottle:
-wash sting sites with sea water
-remove tentacles
-immerse affected limb in hot (45deg) water for 20 mins

Question 2

Tetanus vaccine & tetanus immunoglobulin - indications for prophylaxis (after wound)?

Answer 2

Vaccine:
-if 5-10 years since last dose AND dirty wound
-if >10 years since last dose
-if less than 3 doses of vaccine in history (for all wounds)

Immunoglobulin:
-Only if less than 3 doses of vaccine in history AND dirty wound

Question 3

Red back bite management (3)

Answer 3

Symptomatic:
-Ice pack for relief
-NSAIDs/paracetamol
-Tetanus

No pressure bandage

Question 4

Abx for localised bite and clenched-fist injury infections
-Without systemic symptoms
-With systemic symptoms

Answer 4

-Augmentin DF 875/125mg BD 5/7 (metronidazole + doxy if allergic)

-IV Augmentin

Question 5

Concussion Management steps

Answer 5

○ Cognitive rest 24-48 hours
○ Gradual/progressive more physically/cognitively active, as long as symptoms don’t worsen
§ Minimum 1 week of stepwise activity before normal activity
§ F/u At least review on day 5-7
-Avoid driving, NSAIDs/aspirin, alcohol or sedatives

Refer if symptoms >2 weeks for adults, >4 weeks in kids