RESUMO
Carotid artery dissection is an important cause of stroke, especially in the young. We present a 43-year-old lady, with a known background of headaches, who was referred to the Emergency Department with a headache, dilated pupil, and acute monocular blurring of vision. She was later found to have an internal carotid artery dissection (ICAD) with diffuse ipsilateral hemispheric involvement after being initially managed for atypical optic neuritis. This case report aims to provide further insight into an atypical presentation of a carotid artery dissection, with the intent of assisting the clinician in identifying such cases during the initial presentation.
RESUMO
Singapore was one of the earliest countries affected by COVID-19, outside China. EDs in Singapore faced a surge of confirmed cases of COVID-19 patients, which stretched their resources. Here we describe how we adopted strategic changes using the identify-isolate-inform tool to improve the evaluation, treatment and management of COVID-19 patients. During this pandemic, information technology integration, modifications to the electronic medical record and essential enhancements to the dashboard were implemented in a timely manner to match the clinical needs. Considerations for an isolation facility within an ED are especially important for future outbreaks.