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CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
Just a routine day at your hospital, your next patient has a chief complaint of headache…
Initial Vitals
- Temp 98.8
- HR 88
- RR 16
- BP 130/80
- O2 99%
Critical Actions
- Identify Acute Angle Closure Glaucoma
- Initiate Appropriate Treatment for Acute Angle Closure Glaucoma
- Emergent Consult to Ophthalmology
- Recheck Intra-Ocular Pressure After Initiating Treatment
Dangerous Actions
- Giving NSAIDS (The Patient Had This on Allergy List)
- Performing a Lateral Canthotomy
Final Diagnosis
Acute Angle Closure Glaucoma
Tips and Tricks
Do not be surprised or scared when an examiner has a monotone voice and flat affect
Additional Reading
- Management of acute angle closure glaucoma (PubMed)
- Basic approach to eye complaints (EM Clerkship)
Hello, would acetazolamide be contraindicated in this patient since she has kidney disease? Cool podcast
My understanding is that acetazolamide is contraindicated if patient has severe renal implement. When in doubt, I call pharmacy.
Thanks for your reply! Do you think they would take points off if you gave it without consulting pharmacy in this case (or not, because the severity nor any h/o kidney transplant wasn’t mentioned)?
I doubt they would take off many points for that