Munad Khan

We report the case of a 46-year-old man who initially presented with macroscopic haematuria. Although initially concerning for a malignancy in the bladder, histology demonstrated a primary bladder amyloidosis that has remained stable for 6 years since the initial diagnosis. Primary bladder amyloidosis is an important clinical entity that can mimic bladder malignancy on clinical history, radiological investigation and cystoscopic evaluation.

In advanced disease, prostate cancer is well known to invade locally as well as metastasise to distant locations. Metastases occur commonly in lymph nodes and bone but have also been known to involve certain visceral organs, particularly the lungs. Involvement of soft tissue by metastases is far less common, particularly in the context of cancer recurrence.

We hypothesise that there are patient characteristics and/or ED system variables that act as barriers to the administration of analgesia, NIA and early analgesia. This study aimed to determine these barriers in order to inform further research and the development of intervention initiatives aimed at mitigating their effect. In our ED, credentialled nursing staff are able to administer NIA to patients who are aged 14?years or more (no upper limit), weigh >40?kg and who have a triage category 2–5.