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6 | Follower
Survive:ED
01.03.2024
Sensitivity is the number of people who have a test that is positive that have the thing you are looking for. In medicine, this is usually a disease. We like sensitive tests in medicine…
27.02.2024
As an EM Doc you do a lot of tests. You know about them, and you know that negative tests don’t always rule out a disease, you know that positive tests can be false positives (patients don’t have …
22.02.2024
Speed and efficiency for doctors and AHPs starting out in ED. Lots of people are worried about their speed in EM. This is the time it takes to see a patient. In the bad old days (maybe …
19.02.2024
We have all experienced the ED in the dire state it is in in the morning with a dejected broken night team filing into the handover room, giant waits on the tracker screen, apologies, unsaid recrim…
30.11.2022
So in the last post I established: Lactate is a base. Lactate production retards cellular acidosis. Lactate is produced all the time. Lactate is fuel. I have suggested that the traditional lactate …
My department has just started using the HEART score to help risk stratify chest pain patients. Now chest pain/ACS rule out is a large portion of the ED’s workload, with that workload spilli…
An old man is wheeled into resus. His GCS hovers around 10. No carers have come with him, you find out from the paramedics that the care home staff were alerted to a thump as he fell out of bed. …
Ask any medical student (when they are sober) the clinical features of an Acute Coronary Syndrome they’ll look at you funny for a bit, then talk of severe, left sided chest pain radiating th…
There’s a lady in Resus, she’s 46, she’s got a history of mental health problems. Her husband tells you she’s been gradually more lethargic over the last few days. He called the ambulance today b…
Recently missed an Addisonian crisis. Here’s a brief summary of the case. 61 y o female attended the ED after seeing her GP with vaginal bleeding. GP sent the patient to the ED fo…
We have all seen a little old lady crumpled onto a hospital trolley. Referred in eye-rollingly from their family who visited the nursing home and meekly say ‘she is more confused than normal&…
What is lactate? A good medical student will tell you something along the lines of “Lactate is a byproduct of anaerobic respiration that is produced in response to cellular hypoxia secondary to in…
Presentations to the ED with acute dyspnoea are a bit of challenge. History, examination and tests are used to decide if people have heart failure, pneumonia, COPD, or something else. I think dia…
So an elderly gentleman comes into the department. He lives in a care home, he has a catheter, and he’s got a mild pyrexia, slightly more muddled than normal and some suprapubic tenderness. …