ER Call Presentation by Dr. Arfa from CMA.

ER presentation.

1. ER POST - CALL On Call Team Dr Zia (SR) Dr. Yusra Dr. Abdullah August 24th 2025

2. Case 01: Patient profile : Pt Nawaz Ali Age: 14 years /M P/C : History of trauma to left toe 01 hour ago. Vitals : BP 125/70 Pulse 90 R/R 30 O/E : Nail detached from nail bed . Peripheral pulses palpable. Movements intact.

3. PRE-OP POST-OP

4. Management Plan: Wound was washed with normal saline. N ail was removed under local anesthesia . Dressing done. Patient discharged on antibiotics and painkillers.

5. Case 02: Patient profile: Khursheed Bibi Age: 47 years/F Presenting complain Presented with generalized abdominal pai n started as epigestric pain radiating to back for 1 day with no relieving factor associated with nausea and 01 episode or fever 101F yesterday.there was no history of vomiting snd consipation CO- Morbs : Diabetic and hypertensive for 3 years Vitals : BP 140/100 Pulse 88 R/R 24 temp 100 O/E : Abdomen was soft, generalized abdominal tender.Bowel sound audible, Stool and flatus passed in morning

6. Management Plan: Inj R/L 1L iv 60 ml/ hr Inj 2sum 2g iv BD Inj . Toradol IV STAT Inj. Nospa IV STAT Inj. Provas 1g IV STAT Inj. Risek 40mg IV STAT Inj. Kinz 6cc and maxalone IV STAT Keep patient pain free. Investigations advised: Ultrasound abdomen CXR(PA View) with dome of diaphram X-ray abdomen erect & supine CBC Serum Amylase and Lipase ECG

7. Case 03: Patient profile : Ameera F D/O : Age: 17 yrs old Presenting complain : Present with pain in right iliac fossa for 1 day.pain was sudden in onset progressive and savere in nature aggrevated by laying and not relieved by medications assosiated with f ever 101 f for 1 day documented. Ther e was no history of nausea, vomiting, constipation and burning micturation . Co- morbs : Non-significant.

8. Vitals: BP 110/70 Pulse 112 Temp 101 Resp rate 24

9. O/E : Abdomen was soft, tender in right iliac fossa and non distended Anemic look Investigations: Ultrasound abdomen CBC

10. Plan: Laproscopic appendectomy Intraoperative findings: Acutely infalmed appendix