By Chris Roseveare
Acute medication is the relevant a part of beginning and professional common scientific education and is among the so much speedily increasing united kingdom health center specialties.
Acute drugs: medical situations Uncovered combines sufferer circumstances and results, drawn from real-life stories, near to the curriculum for education often (Acute) drugs. It offers self-assessment MCQs, EMQs and SAQs to offer clinical scholars, junior medical professionals, nurses and allied healthcare pros the right education for all times at the wards.
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Additional resources for Acute Medicine: Clinical Cases Uncovered
Look for ‘obvious’ causes: haemorrhage, fluid loss, cardiac arrest • Check for cardiac causes: assess the rate and rhythm on a cardiac monitor (see p. 14) and 12-lead ECG and exclude obvious ST elevation myocardial infarction (STEMI) (see Case 1 and pp. 20–23) • If the patient is cool, pale and sweaty with a weak, thready pulse consider hypovolaemia to be the most likely cause • If the patient is warm with a large volume pulse and low diastolic pressure consider sepsis (see Case 8) What should be done?
58 An acute physician’s guide to the ECG Interpretation of the ECG is one of the key skills required of a clinician working in acute medicine. There are many causes of an abnormal ECG and the many abnormalities that can be identified can help in establishing a diagnosis. Some of these are covered in the relevant cases and there are numerous textbooks on this subject. The intention here is to concentrate on two key areas of relevance to the acute physician. These can be summarised in the form of two questions.
By the time the ambulance arrives the pain has resolved, but the patient reluctantly agrees to being brought to hospital. On arrival in the accident and emergency 45 department he appears well with a normal ECG. Close questioning reveals a long history of similar symptoms that have been investigated in the past and attributed to gastro-oesophageal reflux. Scenario 2 A 45-year-old man is awoken by chest pain. He asks his wife to call for an ambulance. The pain subsides spontaneously within 30 min and he appears well on arrival in hospital with a normal ECG.