A man in his 50s with a history of end-stage kidney disease on haemodialysis and chronic mental health issues underwent thoracoabdominal CT to characterise a prolonged lower respiratory tract infection. A single metallic density foreign object was noted within the lower oesophagus. (Figure 1)...
Taking medicines as prescribed (Picture Quiz) Read More
Acute dyspnea represents one of the most common presentations to the emergency department. Identifying the cause of this non-specific symptom among patients with complex medical histories can be challenging.This case report describes a patient in their 60s with worsening dyspnea on exertion, fatigue and orthopnea on the background of a single chamber pacemaker. Our case...
We present the case of an 81 year old man, admitted with ataxia and hyponatraemia. Biochemical analysis was suggestive of Syndrome of Inappropriate ADH (SiADH) which was initially attributed to a recent respiratory infection or treatment with omeprazole. Neurological symptoms worsened despite normalisation of sodium levels and further examination revealed generalised areflexia; subsequent investigation by...
An Unusual Cause of Acute Hyponatraemia Read More
Point of care ultrasound (POCUS) is increasing in use and popularity as the technology advances and understanding deepens. For many specialities such as Acute Internal Medicine and Emergency Medicine, POCUS is now mandated in the curriculum. The benefits of POCUS have been identified in multiple settings however currently there is little literature focusing on POCUS...
The training of Acute Physicians is crucial for future delivery of high-quality urgent care. The 2024 Acute Medicine Trainee Survey gathered 124 responses, assessing training satisfaction, challenges, and progress since the 2022 curriculum update. Most trainees (66.2%) reported satisfaction, with access to training in Point-of-Care Ultrasound (POCUS) improving (74.7% vs. 63% in 2023). Disparities in...
Acute Medicine Trainee Survey 2024 Read More
Background: The prevalence of acute pulmonary embolism (PE) among patients hospitalized with pneumonia and its association with adverse outcomes remain uncertain.Methods: Data from the US National Inpatient Sample between 2016 to 2020 was used to determine the proportion of patients with chief diagnosis of pneumonia that had concomitant PE and to examine the relationship between...
Research has shown an association between body temperature, heart rate and respiratory rate. We speculated that antipyretics could influence this. We performed this study with the aim of clarifying the association.We included 1,612 acutely admitted medically ill patients and registered their use of antipyretics. We performed crude and adjusted linear regression analyses. In adjusted analysis,...
Care of patients in corridors of emergency departments is being normalised in many hospitals across the United Kingdom. Clinicians within Emergency Medicine and Acute Medicine have been discussing the impact of this care on patients, as well as the ‘morale injury’ on the staff looking after them. Whilst the authors of this paper have seen...
The NHS and social care services remain under immense pressure.1 Each part of the system continues to experience demand beyond its capacity which exacerbates the problem. This is most vividly illustrated in urgent and emergency care. Once again, this winter, media is full of pictures of patients in corridors; long queues of ambulances outside of
Editorial – Emergency Departments Corridors are the new Acute Medical Units Read More
Objective: To determine whether front-door discharge decision tools operate at different mortality thresholds.Methods: Three databases searched, for studies testing, deriving or validating front-door risk prediction tools or discharge decision aids, with defined discharge ‘cut-off’, reporting mortality or readmission rates. Studies supporting tools’ inclusion in national guidelines were also included.Results: Twenty-four studies were included, frequently for...