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A 23-year-old man presents to A&E having sustained a blunt force trauma to his head outside a nightclub. On arrival, he has just vomited for the second time and is confused. He is aggressive and claims not to remember the events. He shouts at you that he has no other medical problems, and no collateral history is available.

There is an obvious red swelling above his right brow ridge. There is a substantial ecchymosis overlying the right orbit...

Author Dr Andrew Gardner and Dr Meesha Jogia

A 40-year-old gentleman with no past medical history of note presents to the Emergency Department with increasing shortness of breath, productive cough, fever and pleuritic right sided chest pain for 7 days.

On assessment he is noted to be tachycardic (heart rate 110 bpm), tachypnoeic (respiratory rate 30 breaths/minutes), febrile (temperature 38.0oC), SpO2 of 85% on 15L/min O2 using a non-rebreathe mask and a PaO2 of 8.0 kPa...

Author Dr Lamya Mohammed

Patient transfer to CT

Patient transfer to CT

Posterior Reversible Encephalopathy Syndrome (PRES)

A 51 year old woman is referred from the medical team. She had been admitted with new onset confusion, blurred vision and headache. She has had two tonic-clonic seizures in hospital and the medical registrar is concerned that she is in status epilepticus. She had a background of SLE...

Author Dr Helen Cole

Maternal Collapse

A 31 year old primigravida presents in spontaneous labour at 39+4 weeks gestation. The pregnancy has been uncomplicated thus far. On initial vaginal examination her cervix is 4 cm dilated and she in contracting regularly. She is in significant pain and requests an epidural...

Author Dr Tim Knowles

Dislodged ETT in a proned patient

Upper GI haemorrhage

A 22 year old female was admitted to the Acute Assessment Unit with shortness of breath. She has a past history of anxiety and depression. The history revealed that she was refusing to eat anything for over a week and was losing weight over the last few months...

Author Dr Abhay Vaidya

Maternal cardiac arrest