All Journals from Hannah Skene
Abstract
Ovarian Hyperstimulation Syndrome (OHSS) is a spectrum of clinical features typically resulting from assisted conception techniques. With 2.35% of all live births in the UK resulting from in-vitro fertilisation (IVF), OHSS is on the rise. Moreover, there has been an increase in the presentation of its complications to GP surgeries and unscheduled acute care services nationwide. This review will discuss signs and symptoms of the increasingly common and potentially fatal complications of OHSS, namely pleural effusion, ascites and thromboembolic events. With such propensity toward critical, life-threatening events it is not only prudent to recognise the population at risk, but also to be aware of the signs, symptoms and complications to expedite treatment and ensure optimum outcome.
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Abstract
Specialist trainees in Acute Medicine have expressed concerns over skills training in the curriculum, compared with skills training in practice. Thus, an online survey was conducted in 2009 to investigate these comments in detail. The responses from 132 trainees were analysed. The results show that the majority of practical skills are being performed by trainees who feel that they have reached a level of competence sufficient to enable them to teach the skill to others. The major causes for concern were highlighted as temporary cardiac pacing, endotracheal intubation and Sengstaken Blakemore tubes. We recommend that these skills should be taught via simulation where not available in practice, but true competence cannot be expected for the majority.
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Abstract
Background: NHS London released commissioning standards for Adult emergency services in September 2011. The Pan-London Acute Medicine Network (PLAN) agreed to survey its members regarding these standards.
Method: A web-based survey asked PLAN members to comment on the standards which were most relevant to Consultant-delivered care in Acute Medicine. The self-reported rate of compliance with each standard was calculated. The free text comments were grouped by thematic analysis.
Results: 23 responses were received. The compliance with each standard was variable between 9% and 91%.
Discussion: A series of themes are discussed and presented as tips to be considered by those responsible for providing Consultant-delivered care to patients on an AMU.
Conclusion: There is still enormous variation between trusts in how acute medical services are supported by Consultant physicians. The demands on each service and the resources available to trusts differ hugely, therefore the solutions to providing a Consultant-led service need to be tailor made for each AMU.
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An online survey of training in Acute Medicine was conducted to assemble a true picture of the current situation in the UK. The specialty is flourishing, with over 60 trainees having predicted CCT dates in Acute Medicine in 2010 and 2011 alone. 128 respondents highlighted a multitude of issues, including the need for improvements in management and special skills training and part time opportunities. We have used the results of this survey to suggest action points for Deaneries, Training Programme Directors, the Society for Acute Medicine (UK) and those involved in workforce planning.
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It has certainly been a huge year of change for all of us in training posts, and in acute medicine particularly. There are now trainees in Acute Care Common Stem (ACCS) and Core Medical Training (CMT) programmes as well as new posts at ST3 level and above. Across the UK we have doubled the number of specialty trainees in Acute Medicine, and the specialty is in a very strong position.