Summer is here, the weather is great and acute medicine teams across the country will be looking forward to 3 or 4 months with few (if any) acute admissions, long lunch breaks and plenty of time off……..OK so this is just wishful thinking! However, the misconception that bed pressures are seasonal still seems to abound in many circles. How often do we sit in bed management meetings in January and February and hear someone refer to ‘things getting better in the next couple of months’? Such optimism does help us to get through those dark winter days when the only daylight you see is glimpsed through the ward windows as you review the 11th COPD patient in succession. But seasonal bed pressures are not simply confined to Winter. Spring and Summer bring their own challenges. First is the Bank Holiday Trilogy: this year’s Easter backlog was hardly cleared in time for Mayday and Whitsun. On top of this we have pollen, ozone, Economy Class Syndrome and ‘barbeque bowel’, not to mention the dehydrating effect of any ‘heatwave’ which comes our way.

But let’s be positive – Autumn will be with us soon, and with it another important event in the development of the Speciality of Acute Medicine. The Scottish Exhibition and Conference Centre in Glasgow will be the location for the first truly International meeting of the Society for Acute Medicine. This should be a great opportunity for Acute Medicine to show the wider medical world how far we have come as a speciality over the past eight years, and I would urge as many of you as possible to sign up using the on-line registration system via the link: http://www.regonline.com/societyforacutemedicine . The excellent attendance at the Spring meeting in Halifax was encouraging, particularly the large number of SHOs and trainees who made the journey. One Trainee has submitted her own observations on the meeting, which I have included on p. 44. For those of you who were unable to attend I have also included the abstracts from the Free Paper session, along with summaries of the ‘breakout’ sessions. There will not be time in the packed Autumn programme for another Free Paper session (this is planned again for next Spring), but there will be an extensive poster display with a prize for the best poster. Information on how to submit an abstract can be found on the Society’s website.

This edition of the journal contains a range of reviews and case reports, which I hope that readers will find interesting. Hammersley and Edge make a strong case for the development of combined paediatric and adult guidelines for the management of diabetic ketoacidosis, emphasising a more cautious approach to fluid replacement that has been traditionally employed in adult patients. The use of near-patient testing for ketone levels is also discussed, with speculation that this may be of use in the future for prevention of admissions in adults with DKA. Avian influenza may have disapperared from the front pages of Tabloid newspapers in recent times, but the need for vigilance amongst front-line clinicians remains as high as ever. Esmail and Aarons’ review should remind readers of the diagnostic algorithms and treatment options when faced with a suspected case. Syncope and pulmonary embolism complete the review section, the latter providing an extensive review of the diagnostic strategies for this important condition. Treatment of pulmonary embolism will follow in a future edition.


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