Clexane. Admit obs unit and U/S 09:00.
Could check PT before Clexane, then also FBC/WC.
----- Original Message -----
From: "Bill Bailey" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, May 28, 2006 3:14 PM
Subject: Re: A sore leg
> Re-check his obs & exam - if they were all within normal limits ie no
> signs of sepsis, I'd advise him of a probable diagnosis of superficial
> thrombophlebitis, give him some NSAID's [possibly with a PPI given his
> background] and advise him to see his GP again in 48hrs if no improvement.
> I'd be very suprised if anyone in reality would do much more given the
> presentation
>
> Cheers, Bill
> ----- Original Message -----
> From: "Rowley Cottingham" <[log in to unmask]>
> To: "Bill Bailey" <[log in to unmask]>
> Sent: Saturday, May 27, 2006 11:18 PM
> Subject: A sore leg
>
>
>> Male aged 38 comes in by ambulance at 4am. He has a painful left thigh.
>>
>> He is an alcoholic, and went shopping about 3 days ago to get food and
>> drink. He thinks he banged his leg during the trip, and it is still
>> sore. He has come into the ED as the painkillers his GP prescribed 2
>> days ago haven't helped.
>>
>> The ambulance sheet is rich with exclamation marks for calling them at
>> this hour. Their observations are pulse 75bpm, systolic >89mmHg, sats on
>> air 98% and coma scale 15.
>>
>> He has no other medical history of consequence. He has no recent history
>> of travel and has no respiratory symptoms.
>>
>> Review in the department shows a man with stable vitals; pulse 74bpm,
>> temp 35 degC and walking with a little difficulty. General examination
>> is unremarkable; clear chest, normal heart sounds. His leg is tender to
>> touch on the medial aspect of the thigh and reddened; it feels
>> locally hard to the touch. The leg is intact neurovascularly.
>>
>> How would you manage this patient?
>>
>>
>> /Rowley./
>>
>>
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