We all recognise the importance of ensuring patients with Parkinson’s disease (PD) get their medication, but..
What do you do if the patient can’t swallow?
We will need to work out what alternative routes we could use, for example dispensable via NG or patches, and what dose. For an ED clinical it is most likely beyond us and we need help! However, that may be extremely difficult to get especially Out of Hours
Excellent website that can give you options – select the patients normal regime (initially just one line but you can add as many as needed) and press calculate. It gives you a dispensable and patch dose, which can help the discussion with pharmacy about where we can get it
Ditch the Dipstick – for patients >65Yrs or Catheterised!
Approx. 50% of over 65’s and most of those with catheters have asymptomatic bacteriuria. The patient will not benefit from treatment and often gives us premature closure (i.e. we blame a fictitious UTI for the patients symptoms and stop thinking). Read more
Headache is a common presentation to ED and Subarachnoid is the diagnosis we never want to miss. However, working out who needs a scan can be difficult as 50% of patients presenting with a subarachnoid have no neurological deficit.
The Ottawa SAH Rule is a validated tool for deciding who needs as CT scan. The Ottawa team have also done further work to decide which of the patients you do scan need a follow-up LP/CTA and who we could discharge. Read more
Severe pain is the most common reason that patients with sickle cell, will attend the ED. The pain can be agonising (and often underestimated by us), we need to act fast to help ease the symptoms Read more
Registered Medical Practitioners in England and Wales have a statutory duty to notify Public Health about the following diseases. To facilitate rapid treatment and control of outbreaks. (Links to Wikipedia for illustrative purposes)Read more
On the 8th of May we are changing our current troponin test to a HS-Trop (high sensitivity troponin). This will allow us to exclude ACS earlier in the patient journey, however it does mean getting used to new numbers and a new protocol. Read more