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Diccon Lowe

A Nurse Practitioner, with a love of informal and spontaneous learning and teaching, event medicine and coffee. Mostly coffee.

 

“Time is an illusion. Lunch time doubly so.” – Douglas Adams.

Quick-Wee method

Have you ever wanted an infant to PU faster?

Gentle suprapubic cutaneous stimulation with gauze soaked in cold fluid (the Quick-Wee method) led to a clinically and statistically significant increase in voiding and successful urine collection within five minutes for infants aged 1-12 months

An ideal job to be given to parents/carers

Anion Gap & Metabolic Acidosis

The anion gap (AG) represents the amount of unmeasured anions in the plasma.

AG =([Na]+[K]) – ([HCO3]+[Cl])

The main contributor to the AG is albumin (decreasing albumin by 1g/l reduces the AG by 0.25) so hypoalbuminaemia can falsely reduce the AG.

Corrected AG = AG + (0.25*(40-[albumin]))

(However, this relies on getting LFT’s back about 1 hour) Read more

A-a gradient

A-a gradient = Alveolar Oxygen – arterial Oxygen

This is “relatively” simple way of working out if the paO2 on a ABG is normal, and demonstrates V/Q mismatch well. V/Q mismatch is simple terms is either an area of the lung either under ventilated(pneumonia) or under perfused (PE). Read more

Locum Induction

NEW locum staff we need to introduce them to our department and processes.

Complete & Sign – check list 

Please familiaries yourself with the EMBeds page for ED Essentials for Newbies

Locum Doctor IT access

  • Locum doctors to be assigned a unique log in by Flexible Workforce when booked for a shift.
  • If the details are not communicated prior to starting the shift, this should be escalated to Flexible Workforce in hours, and the On Call IT team out of hours.
  • Log in details can expire if they are not used frequently, in these instances the IT department can reactivate them.
  • Locum logins should never be used due to issues with Information Governance.

COPD think VBG

Why VBG instead of ABG?

  • Pain – we all know and warn our patients ABG’s are painful. Patients know it to and delay presentation.
  • Number of bloods taken – patients attending with COPD will generally have venous bloods taken at triage. Would you want stabbing again if it could be avoided?

Read more

Why choose EM?

It’s a good question in today’s climate of increasing patient numbers and complexity. Specialities that offer you the illusion of more control can seem attractive. But Emergency Medicine picks you, and can offer an exciting and varied career. Read more