Author: Robert Hirst / Editor: Fiona Mendes / Reviewer: Rafeeq Ahmed Sulaiman / Codes: / Published: 20/09/2023
A 77-year-old man presents to your Emergency Department (ED) by ambulance with his wife.
He awoke this morning with nausea, vomiting, and difficulty walking. He says he “feels like the room is spinning.” He is unable to get off the bed and is markedly ataxic.
Your initial assessment shows:
Airway: Patent airway.
Breathing: Oxygen saturations 97% on room air, respiratory rate 20 breaths per minute. Chest clear.
Circulation: Heart rate 89 beats per minute, irregular heart rate. BP 173/89. Capillary refill time 2 seconds
Disability: GCS 15/15. Temperature 37.1 degrees Celcius Blood glucose 12.2. Pupils 3mm, both equal & reactive to light.
He is markedly ataxic. He has no hearing loss.
Exposure: He has some vomit on his shirt, but no other distinguishing features. His tympanic membranes look unremarkable on otoscopy.
