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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… Read more

We are frequently asked to check the lactate on Venous Blood Gases (VBG’s), by the nursing staff. However, remember to look at the first result… Read more

Asthma is common and potentially fatal. Severity – Severe or Life threatening – think RESUS Treatment within 30 min – bronchodilators and steroids should bee… Read more

COPD patients vary widely, due to their comorbidities, social circumstances, and wishes. So choosing the best treatment pathway for the patient can be complex. Involve… Read more

NHS England has introduced the use of a “40 step desaturation test” into discharge planning from the ED. You will have heard Covid -19 patients… Read more

There is increasing evidence that Awake Self-Proning of our Covid-19 patients can improve oxygenation. Proning the patient can has several effects which can dramatically improve their SaO2… Read more

Deteriorating Patients Early senior decision making around DNACPR, is vital for both staff, patients, and families. Document decsion making and communications clearly There will be… Read more

The rules have changed since 25th march 2020 on death certification, below is a brief summary of how this might affect us. We are aiming… Read more

Experience is showing that those with diabetic patients with COVID-19 are more likely to develop DKA/HSS. However, treating them with the traditional large amount of… Read more

2 video links to PHE how to Don and Doff your PPE Read more

Due to the limited capacity when referring patients to the “New Arrhythmia Clinic” we MUST Send a BNP We don’t need to wait for the result… Read more

Any patient presenting to ED with ONLY Ophthalmic symptoms should be referred directly by the ED triage team to Ophthalmology: Referral 08:30 – 17:30 Mon-Fri,… Read more

As you are aware during the Covid-19 pandemic our use of oxygen has increased. However, supply is limited and most hospitals can only generate 3000-5000l/min… Read more

AKA: Paediatric Inflammatory Multi-system Syndrome – Temporally associated with SARS-CoV 2  Although COVID-19 seems a benign disease in almost all children there are increasing evidence (however… Read more

To improve management and maintain protection for staff and patients we have created a RespED at both sites, much of the flow chart is based… Read more

As we know COVID-19 is putting an incredible burden on resources, especially for higher level respiratory support. It is important to target those resourses in… Read more

During the Covid-19 pandemic alternatives to LMWH have been agreed – [For those who can’t inject themselves] Read more

British Society of Thoracic Imaging (BSTI) have released a free learning resource containing CXR and CT of confirmed Covid-19 cases, will short history including time… Read more

The 2019-20 Flu season has arrived, and we need to be thinking about who to test and who to treat. Full guide HERE But don’t forget… Read more

Please see the updated SOP for Middle East respiratory syndrome coronavirus. Make sure you are familiar with this protocol and for anymore information please contact… Read more

CAP is far less common than URTI’s, however, it needs to be considered within your differentials. Depending on severity there is a guide to investigation… Read more

BTS Definition of CAP Signs of acute Lower Respiratory Tract illness (LRTI) [Cough] &:  ≥1 other LRTI Symptom [Pleuritic pain, Tachypnea, Dyspnea, etc] New Focal Chest… Read more

PE is somehow both the most over and under diagnosed condition. with severity ranging from the questionable sub-segmental PE to the Massive PE (an indication… Read more

Unfortunately the the normal pathway for investigation of PE performs poorly in pregnancy RCOG have the following pathway 1. Investigation – of suspected PE Clinical… Read more