(DK Satchithananda, A Macnab & AJF Page) · The following are true of atrial fibrillation: 1. An irregularly irregular pulse is pathognomonic of atrial fibrillation. 2. Co-ordinated atrial activity at around 300 beats per minute is usually apparent on the 12 lead ECG. 3. Ventricular rate is usually between 100-160 beats per minute in untreated […]
Self – Assessment MCQ Questions for Vol.1 No.3 Read More
2002 Volume 1: 2 Cellulitis Diabetic Ketoacidosis Ventilation of the Asthmatic Pulmonary Embolism Anaphylaxis Volume 1: 3 Medical Emergencies in Pregnancy Non-Variceal GI Bleeding Atrial Fibrillation Neuroleptic Malignant syndrome / serotonin syndrome Myaesthenia Gravis
Provisional Cycle of Reviews Read More
Acute Medicine is a hot topic which has been discussed extensively throughout the United Kingdom over the last decade. However, recent developments demonstrate a move from discussion to action, with an increasing number of Consultant appointments in Acute Medicine, the development of the Society for Acute Medicine (UK) and, more recently, discussions within the JCHMT to develop Acute Medicine as a subspecialty of General (Internal) Medicine. This latter step is very significant as we may soon be in the position to develop training programmes for Specialty Registrars in Acute Medicine which will ultimately ensure that they have the appropriate clinical and organisational skills to support the delivery of emergency care.
Acute Medicine – a new era? Read More
The ability to insert a chest drain safely and painlessly is an important core skill for physicians. This article describes techniques for insertion of larger bore trochar and cannula type chest drains as well as the more recent Seldinger guide-wire type drains. The indications for chest drain insertion will also be reviewed.
Chest Drain Insertion Indications and Techniques Read More
A 33 year old, previously healthy woman was referred to hospital with a 3 month history of cough, 6kg weight loss, dyspnoea and night sweats. She described intermittent expectoration of purulent sputum without haemoptysis. There was no history of recent travel outside UK or contact with tuberculosis. Her general practitioner had treated her with course of amoxycillin followed by ciprofloxacin with no relief.
Pneumonia is not always what it seems Read More
The backdrop of Captain Scott’s Antarctic vessel The Discovery was the setting for the Sixth Meeting of the Society for Acute Medicine in Dundee. Hosted by Dr Mike Jones and Dr Liz Myers, delegates were led on an intrepid adventure exploring developments in Acute Medicine.
Society For Acute Medicine Autumn Meeting 3rd – 4th October 2002 Read More
Abstract
The Neuroleptic Malignant Syndrome and the Serotonin Syndrome are two rare but potentially fatal complications of psychopharmacology. This review focuses on the clinical aspects of these conditions, exploring the diagnosis, differential diagnosis, treatment and prognosis.
The Neuroleptic Malignant and Serotonin Syndromes Read More
Abstract
Medical emergencies in pregnant women pose many challenges if both the baby and mother are to have an optimal outcome. Multidisciplinary team working is essential to ensure that the correct treatment is offered, and that potentially lifesaving options are not discarded because of unwarranted concerns about safety in pregnancy. Expertise should be sought from doctors with a special interest in obstetric medicine.
Clinical problems include those unique to pregnancy such as eclampsia or acute fatty liver of pregnancy, exacerbations of chronic medical diseases some of which can be predicted such as pulmonary hypertension, or conditions which have an increased frequency in pregnancy including thromboembolism, urinary tract infection and Bell’s palsy. Cardiopulmonary resuscitation in pregnancy should be managed in the left lateral position, with early recourse to delivery of the fetus.
Management of Medical Emergencies in Pregnancy Read More
Abstract
Myasthenia gravis was first described 300 years ago, but today is one of the most well characterised autoimmune diseases. Whilst its prognosis was previously grave, cholinergic and immunomodulatory therapy has greatly improved survival over the last two decades. Improved recognition of the condition and effective therapy has transformed this previously debilitating and often fatal condition into an eminently treatable and reversible condition.
Diagnosis and Management of Myasthenia Gravis Read More
Abstract
Upper gastrointestinal haemorrhage remains a common medical emergency with significant mortality. Management depends on appropriate and timely resuscitation, therapeutic endoscopy and surgery. This is made possible by a multidisciplinary approach incorporating protocols and scoring systems to aid risk stratification. Communication between members of the multidisciplinary team is important in determining the outcome for patients with high predicted mortality.
Acute non – variceal upper gastrointestinal haemorrhage Read More