Serious or Not?
Another day, another call, another common complaint, but... a serious condition? Could it be possible to miss a potentially life-threatening diagnosis because it presents similarly to other common conditions? Revisit some signs and symptoms that may seem a little too easy.
Weakness, tingling, numbness, pins and needles; a sensation that does not feel right... signs of a breath of conditions ranging from anxiety and complex acid-base problems, to neurology including strokes and transient ischemic attacks.
"Settle your breathing" to ease abnormal sensations makes sense, but hyperventilation and abnormal sensations can be caused by an underlying condition, such as an acid-base abnormality, cardiac event or respiratory problem requiring entirely different treatment. Take very thorough assessments, and be aware of other complaints including weakness, lethargy and subjective descriptions both with and without seemingly obvious causes; including embolisms, infections, aneurysms, impending seizures, nutritional/electrolyte problems, and drug toxicities (or withdrawals).
Abdominal pain; common , varied, and should not be dismissed. Abdominal examination including inspection, auscultation, palpation and percussion should occur, but even then may it not yield a provisional diagnosis. Abdominal pain should also not be considered an isolated finding; thorough assessments including full vital signs and history-taking should also occur. Consider these serious conditions which may or may not have extremely varying pain; appendicitis, diabetic emergencies (hyper- and hypoglycaemic), bowel obstruction, myocardial infarction, abdominal sepsis, renal colic, traumatic injury, pancreatitis, pelvic inflammatory disease, the rupturing or so-far-undiagnosed-but-could-rupture aortic aneurysm, and many more. Sometimes there will be some indicators of one or several specific conditions, but further investigations need to occur to definitely diagnose many.
A final mention to pediatric patients and those who may be difficult to assess. Diagnosis may be difficult; for example in children with intussusception (intestinal prolapse) there may be some common abdominal complaints or vague symptoms, and communication may be mostly facilitated by another person. Just as in adults, abdominal pains should be taken seriously, and other signs and symptoms may also occur. A sometimes difficult-to-find sign of intussusception is a child pulling their legs up to their chest. You might not see this when treating them, and there is a chance the family might not have even noticed it, but if you are particularly thorough including further questioning of provided information, you might extract a very useful piece of information. Intussusception responds well to early treatment but can be fatal within a few days.
These are only a few examples, and there is a lot of pertinent information which can be found or missed. Some cases are 'clear cut' and straightforward, but that challenging diagnosis might be a few more assessments away with yourself or at hospital.