This paper will focus on those situations and the red flags that suggest their presence and the appropriate response by an emergency room physician. The index of suspicion needs to be raised in the elderly or very young patients. O ther indications for emergency CAT scans in the emergency department would include new types of headaches or the worst headache in a patient's life, suspected stroke, first seizure or an unconscious patient with no clear cause. In a patient with a shunt who is having headache, vomiting or alteration in the level of consciousness it should be considered due to shunt malfunction until proven otherwise. CAT scan and urgent neurosurgical consultation is required since these patients can rapidly deteriorate.
Common things happen commonly and appendicitis is common.
The physician should think appendicitis until proven otherwise in cases of right sided lower abdominal pain or flank pain. Immediate surgical consultation should be obtained in cases where there is a significant suspicion for a surgical abdomen. With an elderly patient it is necessary to maintain a higher level of concern in cases of abdominal pain. Abdominal aortic aneurysm needs to be considered. Pregnancy tests should always be ordered in women of childbearing age who present with abdominal pain to rule-out ectopic pregnancy.