A ruptured abdominal aortic aneurysm (AAA) is a catastrophic cardiovascular emergency which carries high risk of morbidity and mortality. Clinical manifestation includes severe abdominal pain, back or flank pain, syncope, hypotension, gastrointestinal bleeding and cardiovascular collapse. Misdiagnosis is often due to atypical presentation and results in fatal consequences. Rapid diagnosis of ruptured AAA is essential because it influences the patient’s prognosis. Timely and accurate diagnosis can be made in the Emergency Department using point-of-care ultrasound (POCUS) which has high sensitivity and specificity. We report a case of an elderly male who came with non-specific abdominal pain to the Emergency Department. Timely diagnosis of ruptured AAA was made with POCUS. The diagnosis was made by a non-radiologist using POCUS, however, the decision for ruptured AAA repair was only made by surgical team following computed tomography scan of the abdomen.
Aortic Aneurysm, Abdominal

Carbon monoxide poisoning is described as “silent killer” because carbon monoxide is an odourless, colourless, tasteless gas and the clinical presentation is non-specific. A two-month-old boy presented with rapid breathing, irritable, and refused to be fed. The symptoms occurred approximately 1 h after waiting with his father in the car with the engine running. The father also presented with symptom of carbon monoxide poisoning. The child had respiratory distress and sinus tachycardia. The child’s carboxyhaemoglobin level was normal, but the father’s level was elevated. Serum lactate and troponin I were raised. He was given 100% normobaric oxygen and was admitted. Subsequently his condition improved and was discharged the next day. Infants are more prone to the effects of carbon monoxide poisoning. When an infant suddenly become unwell, high index of suspicion and detail collaborative history are required so that carbon monoxide poisoning will not be missed out.
Carbon Monoxide