EM Didactic - December 26, 2016 - By Sagar Galwankar
Summary:
- Basic Approach should be T/P/R/BP/Pulse Ox
- I always order a CBC LFT RFT EKG Trop CXR. Looking for Rhythm abnormalities is also important. Fever can also cause Gabrahat.
- In Females in the Pregnancy Age group a HCG-UA is ordered
- If Patient has SOB I will R/O Thoracic Causes like Dissection/Pneumothorax and PE.
- If Patient has a presentation of Altered Mental Status I always order a CT Head.
- If Toxicology screen is available, I will order one.
- Co-Symptoms should guide further investigations.
- Discussing with the Relatives in key to educate them- that this is not Hysteria / Tension / Stress. Those are the diagnosis to be considered once Major Life threatening causes are ruled out.
- I have often Seen Marital Discord / Intimate Partner Abuse to be causes of GABRAHAT. So Going deeper into the history. Sitting with the patient with Privacy is the key.
- Anxiety / Panic attack also can be on the differential once Major causes are ruled out.
- Being a Compassionate Emergency Physician is the key. Communication is the answer and Competency to Care is crucial.
- GABRAHAT CAN KILL !