All Journals from Tom Heaps
A 56-year-old female presents to the emergency department 6h after taking an overdose of verapamil MR 120mg x 28 capsules. She has a past medical history of hypertension and atrial flutter. On admission her GCS is 15, HR 50/min, BP 100/64, Capillary blood glucose (CBG) 10.2. ECG shows sinus bradycardia with prolongation of the PR interval. You estimate her weight to be 60kg.
Please subscribe to see more.
Subscribe
Subscribe
Already a member? Log in here
A 29-year old male presents to the emergency department 1h after an overdose of cocodamol. He admits to taking approximately 60 x 8/500mg tablets, with alcohol, over a 20 minute period. He has a past history of depression, treated by his GP with citalopram 20mg OD. He has no previous history of deliberate self-harm. His past medical history is otherwise unremarkable and he is not on any additional medications. He drinks approximately 40 units of alcohol per week. Physical examination is unremarkable, his pupils are normal diameter and his Glasgow Coma Scale is 15. He weighs 82kg.
This edition of the journal sees the launch of a new regular trainee-orientated section. Over the course of a rolling five-year cycle we will be publishing a series of articles which will cover the ‘Emergency Presentations’, ‘The Top 20 Common Medical Presentations’, ‘Other Important Presentations’ and ‘Practical Procedures’ outlined in the curriculum for Acute Internal Medicine 2009. Articles will take the form of a problem-based review that uses a brief clinical case (real or fictional) and its development to illustrate the assessment, differential diagnosis and management of the common presentations to Acute Medicine. We hope these reviews will highlight recent evidence-based guidelines and provide readers with clinically useful ‘pearls and pitfalls’ from specialist experience that can be easily applied to future practice. Although many of these reviews will be commissioned directly by the editors of the journal, if you do have a particular interest in producing a review relating to a specific curriculum topic, please contact me at tomheaps@hotmail.co.uk. Similarly, I would welcome any early feedback relating to the content and format of this new journal section. This edition features reviews of the management of GI bleeding and paraplegia which I hope will be of interest to readers of various levels of seniority. Dr Joe Wileman has also produced a ‘Journal Watch’ section, which we plan to repeat in future editions (again contact me directly if you are interested in undertaking this for a future edition) and there is a ‘trainee update’ from Alice Miller.