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Don’t forget to have fun
Guide Taken from the Primary Care Dermatology Society(PCDS) other good sourse is DermnetNZ.
A relatively easy way to find out what you’re looking at!
Category: Learning
SIMNews- Issue 2- Acute Pulmonary Oedema
SIMNews- Issue 2
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Running insitu SIM at CHT means we to learn and share our learning
@cazandal, @chftedsim
EMbeds pulmonary oedema guidelines
SIMNews – Issue 3- Anaphylaxis
Sim_NEWS_3___Anaphylaxis
Click here to download the poster
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Running insitu SIM at CHT means we to learn and share our learning
@cazandal, @chftedsim
Methaemoglobinaemia
Q: Why are Smurf’s Blue?
A: Methaemoglobin (MetHb) of course!
– MetHb is produced by oxidisation of the Iron in Haemoglobin (Hb) from Fe2+ to Fe3+
– Fe3+ prevents Hb carrying oxygen (thus produces symptoms of hypoxia)
– Often due to chemical ingestion, but may also be genetic
– Treated with Methyl Blue & supportive measures
Hypernatraemia
Hypernatraemia is a not a common presentation in ED, as intense thirst often prevents significant hypernatraemia in neurologically intact individuals. So… Mortality rates are high (20-70%) and the severity of hypernatraemia has been shown be an independent predictor of mortality.
However, there is little good data on hypernatremia to base guidance on, and definitions vary within the literature
Hair Apposition Technique – HAT
Really useful method to close linear head wounds that you wouldn’t normally use glue for within the hair (esp. in children)
- Reduced pain
- Reduced follow up
- increased patient satisfaction (less pain and no need to see again)
- Faster and increased staff satisfaction
Journal Club – Jan 2021
Acute Kidney Injury After Computed Tomography: A Meta-analysis
Wed 27th Jan 12-13:00 – OUTCOME
TEAMS meeting Read more
Assessing Functional Leg Weakness
When patients present with functional symptoms. It can be difficult to discern whether if it is an actual or functional weakness. And it can be even more difficult to convince the patient. However these tests can not only help you workout what is happening, but also demonstrate function to the patient. Read more
CPAP Set-Up
NIPPV 3 machines are used throughout the trust to deliver NIV and CPAP – and should be commenced in ED if transfer to ward/ICU is adding significant delay
- NIV/CPAP is an Aerosol Generating Proceedure (AGP)
- Staff must wear full APG PPE
- In Side room with a door
- Door Marked with APG sign – HERE
- CPAP/EPAP levels of 8-15cmH2O
This video demonstrates how to set up CPAP on the NIPPV 3
Rash/Derm Guide
Rash – Apearance
- Hypopigmentation (white or lighter coloured areas of skin)
- Hyperpigmentation (darker coloured areas of skin)
- Shape of lesion or rash
- Scaly / rough / peeling / crusty
- Patches / plaques (patch = larger flat area of skin change / plaque = an elevated patch)
- Macules / papules (macule = small flat lesion / papule = small raised lesion)
- Nodules (a larger raised lesion)
- Pustules (small pus-filled lesions) and boils
- Vesicles / blisters (bullae)
- Ulceration / necrosis
- Vascular
- Structural changes (firm or weak patches, or altered elasticity)
Rash – Site
- Erythroderma (a rash that covers 90% or more of the skin surface)
- Scalp and hair (hair loss or excess hair)
- Face and neck
- Eyelids
- Nose
- Mouth
- Lips
- Ears
- Neck / upper chest
- Trunk (chest, abdomen and back)
- Flexures (body folds eg armpits, groins and under breasts)
- Limbs – arms and legs
- Hands
- Feet
- Nails
- Genital
Lesions
Brown/Black/Blue
Red/Pink/Purple/Skin Colour
- Flat, and smooth to touch
- Scaly / crusty (usually rough to touch)
- Raised, and soft or wobbly to touch – either sessile (broad-based) or pedunculated (on a stalk)
- Raised, smooth and firm to touch, skin-coloured
- Raised, smooth and firm to touch, pink-red or purple
- Subcutaneous / deep seated (much of the lesion sits under the skin surface)
White
Yellow
Orange
Skin Conditions (DermnetNZ – a bit clunckier)
- Dermatopathology index
- Acne and other follicular disorders
- Blistering skin conditions
- Deep skin disorders
- Differential diagnosis of itchy skin
- Disorders of sweating and sweat
- Eczema, dermatitis and allergies
- Erosions and ulcers
- Immunological disorders
- Lesions, tumours and cancers
- Pigmentation problems
- Pustular skin conditions
- Reactions to external agents
- Scaly skin conditions
- Skin of colour
- Skin signs and systemic disease
- The mind and the skin
- Tropical skin diseases
- Vascular skin problems
