Further investigations revealed a negative autoimmune screen and aspergillus preciptins, but a raised total IgE level of 350ku/l. She underwent a bronchoscopy and lavage which was negative for routine culture and acid-fast bacilli, and revealed a normal cell differential.
A traveller with haemoptysis – Answers Read More
We read with interest the review of the OPAT service in Birmingham, featured in the most recent issue of Acute Medicine.1 Could the authors confirm the percentages of patients deemed suitable for outpatient therapy with the various conditions compared to the totals presenting to their organisation?
Outpatient parenteral antibiotic therapy for cellulitis Read More
The article “The impact of education on the knowledge and documentation of Driver and Vehicle Licensing Agency (DVLA) driving restrictions by doctors”1 was interesting and I agree that doctors (especially those working in the acute / emergency setting) should have a good knowledge on when to advise a person to refrain from driving.
The clinician’s responsibility in relation to DVLA guidance Read More
We enjoyed the recent article by Heaps and Gormley.1 It highlights both the importance of electrolyte disturbance and the QT interval, in the context of acute drug overdose or substance misuse.
Hypokalaemia, Drugs and the QT interval – A Recipe for Disaster Read More
A 22 year old woman was admitted to hospital after coughing up approximately 500ml of fresh blood. She was a lifelong non-smoker with no significant prior respiratory history; however she described coughing up a small quantity of fresh blood on one occasion during the previous year. She had also been diagnosed with chronic idiopathic urticaria one year earlier.
A traveller with haemoptysis Read More
Acute Medicine 30 2011; 10(1): 29-31
V K Patel, B Warner, A Ceccherini & B Mearns
An unusual cause of bilateral deep vein thrombosis in a young adult patient
Erratum – Acute Medicine 30 2011; 10(1): 29-31 Read More
The quality of care in AMU has a significant and disproportionate impact on hospital outcomes. Early expert involvement reduces mortality and reduces the risk of hospital associated harm by shortening length of stay.1,2 Sensitive communication during the frightening initial phase of hospital admission can enhance patient and family experience and reduce anxiety.3,4 The inception and development of Acute Medicine as a specialty has done a great deal to improve the early hours of hospital care, but there is still room for improvement. The professionals who work in AMUs are good at delivering excellent care to the patient in front of them, but an extra step is needed to ensure reliable performance, with every patient getting every item of care that they need, whatever the time, day or night. It can be frustrating and difficult to make the changes needed to achieve this and it requires skills that do not ‘come as standard’ in the current medical or nursing curriculum.
Quality Improvement and Acute Medicine Read More
Falls are common amongst older adults inf licting a substantial socioeconomic burden. Aetiology is often multifactorial. Comprehensive individualised assessment is pivotal to direct effective interventions.
Falls in older people – An overview for the acute physician Read More
Shock may not be the commonest scenario encountered within the average clinical take, but unless rapidly recognised and managed appropriately, it carries an extremely high mortality. Shock is defined as inadequate tissue perfusion and is a consequence of a number of different clinical conditions. Hypotension is often, but not always, present. Blood pressure (BP) is a product of cardiac output (CO) and peripheral resistance (PR) as defined in the following equation:
The emergency management of the patient presenting with shock Read More
Journals were reviewed between January and April 2011. The journals reviewed include: American Journal of Medicine, Annals of Internal Medicine, Archives of Internal Medicine, British Medical Journal, Gut, Heart, Journal of Hospital Infection, Journal of the American Medical Association (JAMA), The Lancet, Lancet Neurology, New England Journal of Medicine and Thorax. The articles chosen are those which were felt to have particular relevance to Acute Physicians.