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Anterior shoulder dislocation — RCPSC EM MCQ

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HardMusculoskeletalAnterior shoulder dislocationRCPSC EM

An adult deliberately drinks an unknown volume of drain cleaner and arrives without stridor or abdominal tenderness. What is the most appropriate immediate management?

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Correct answer: E — Keep nil by mouth with poison and gastroenterology advice

The best answer is “Keep nil by mouth with poison and gastroenterology advice”. Deliberate caustic ingestion can cause serious occult injury even when the initial examination is reassuring. Assess the airway, keep the patient nil by mouth, obtain poison-centre advice and arrange GI endoscopy, generally within 12–24 hours. Emesis, dilution or neutralization and activated charcoal can worsen injury or have no benefit; empiric steroid is not routine.

Reference: Emergency Care BC: Caustic Injuries—Diagnosis and Management: https://emergencycarebc.ca/clinical_resource/clinical-summary/caustic-injuries-diagnosis-and-management-2/