Volume 14, Issue 2, Pages 41 – 96 (2015)

ESIM Winter School 2015, Riga, Latvia

Trainee Section, Volume 14, Issue 2, Pages 41 - 96 (2015)

Of course we were delighted to have ‘won’ something for our efforts although neither of us really new what we had ‘won’. A trip to the ESIM Winter School in Riga, Latvia we were told was our prize courtesy of the Society for Acute Medicine (SAM). But what is ESIM? It stands for the European School of Internal Medicine (ESIM), an educational part of a larger organisation the European Federation of Internal Medicine (EFIM). We both have to confess we knew nothing about either organisation.

ESIM Winter School 2015, Riga, Latvia Read More

Problem-Based Review: Non Vitamin K Antagonist Oral Anticoagulants for the Acute Physician

Trainee Section, Volume 14, Issue 2, Pages 41 - 96 (2015)

Non-vitamin K antagonist oral anticoagulants (NOACs), are direct anticoagulants which inhibit specific coagulation factors and function as anticoagulants. Three NOACs are currently licensed in the United Kingdom: dabigatran, a thrombin inhibitor, and rivaroxaban and apixaban, antagonists of factor Xa. They are set to change the anticoagulant landscape, which was previously ruled by warfarin and heparins. Their advantages including oral formulations, rapid onset and offset of action, predictable pharmacokinetics, no requirement for routine blood monitoring or dose adjustment and very few drug interactions. The increasing use of these drugs means the acute medicine physicians are likely to encounter patients who have been taking them. This article reviews some of the challenging clinical situations in which this may arise.

Problem-Based Review: Non Vitamin K Antagonist Oral Anticoagulants for the Acute Physician Read More

Acute Internal Medicine Trainee Survey 2015

Trainee Section, Volume 14, Issue 2, Pages 41 - 96 (2015)

Objectives: To ascertain current Acute Internal Medicine (AIM) trainees’ opinions on their training programme, practical procedures, specialist skills and AIM as a specialty. This can then be used to feedback to the national training committee to help shape training priorities.

Methods: Online survey sent to all AIM Higher Specialty Trainees registered on the Society for Acute Medicine database, and advertised through e-mail communication and social media.

Results: The majority of trainees (55.5%) were quite happy or very happy with their training currently, although significant difficulties were highlighted with time off for specialist skill training and difficulty achieving certain procedural skills. The majority of trainees believe ultrasound should form a core component of AIM training (82.3%). A high proportion of trainees would recommend AIM as a specialty despite these difficulties.

Conclusions: A number of issues were highlighted causing difficulties within AIM training, despite which the vast majority of trainees would recommend AIM as a career choice. The results were fed back to the training committee in March.

Acute Internal Medicine Trainee Survey 2015 Read More

Low Oxygen Affinity Variant Haemoglobin in an elderly woman presenting with low oxygen saturation

Case Reports, Volume 14, Issue 2, Pages 41 - 96 (2015)

Abstract

An asymptomatic 81-year-old woman was referred by her general practitioner regarding a pulse-oximetry oxygen saturation (SpO2) of 74%. An arterial blood gas analysis (ABG) on air showed PaO2 12.9 kPa, oxygen saturation 80%, with normal pH, PaCO2, methaemoglobin and carboxyhaemoglobin levels. After a normal chest x-ray, tinzaparin was administered empirically for possible occult pulmonary embolus. This diagnosis was subsequently excluded with an unremarkable computed tomography pulmonary angiogram (CTPA). She was further investigated as an out patient. DNA globin-gene analysis identified a variant haemoglobin revealed to be haemoglobin Saint Mande (HbSM). Following reassurance regarding the benign nature of her condition, she has remained well.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Low Oxygen Affinity Variant Haemoglobin in an elderly woman presenting with low oxygen saturation Read More

Pleuro-Peritoneal Fistula – An Important Condition to Consider in Patients using Peritoneal Dialysis

Case Reports, Volume 14, Issue 2, Pages 41 - 96 (2015)

Abstract

Pleural effusions are a common finding in patients admitted on the medical take. This case decribes a patient using peritoneal dialysis who presented with progressive dyspnoea. Clinical examination and chest x-ray confirmed the presence of a pleural effusion. Thoracocentesis confirmed a ‘sweet’ effusion (higher pleural: serum glucose content), suggesting a pleuro-peritoneal leak. Optimal management involved switch from peritoneal to haemodialysis and referral to a specialised renal unit. This case highlights the need to consider the diagnosis of pleuro-peritoneal leak in patients using peritoneal dialysis who present to the acute medical unit with pleural effusion.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Pleuro-Peritoneal Fistula – An Important Condition to Consider in Patients using Peritoneal Dialysis Read More

Viewpoint: What is ‘Training’?

Viewpoint, Volume 14, Issue 2, Pages 41 - 96 (2015)

Abstract

This edition’s paper on ‘How doctors spend their time on an AMU’ defines ‘training’ as time spent on senior ward rounds. But the idea that senior ward rounds are training and the rest of work is not is a huge assumption that must be challenged. This article explores some false ideas about postgraduate medical education; why teaching and learning activities needs to be made more explicit, and why we need to stop talking about ‘training’ and start talking about learning. The goal of professional education is expertise, not competence. That can only happen through work-based learning, something to which we need to pay much more attention.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Viewpoint: What is ‘Training’? Read More

Abstracts from Oral Presentations at the Society for Acute Medicine Spring Meeting 2015

Research Audit and Clinical Practice, Volume 14, Issue 2, Pages 41 - 96 (2015)

Over 200 abstracts were submitted for consideration of presentation at the spring meeting of the Society for Acute Medicine, which was held in the Marriott Hotel, Bristol, on 7-8th May 2015. The best of these were selected for oral presentation at a session held on the morning of the 8th May. The abstracts for these presentations are published here.

Please subscribe to see more.
Subscribe
Already a member? Log in here

Abstracts from Oral Presentations at the Society for Acute Medicine Spring Meeting 2015 Read More

How do junior doctors spend their time in an Acute Medical Unit?

Research Audit and Clinical Practice, Volume 14, Issue 2, Pages 41 - 96 (2015)

Introduction

In the UK, postgraduate training for doctors has undergone significant changes over the past decade general practice, etc. During this period, hospital admission rates and bed occupancy have also increased.

Please subscribe to see more.
Subscribe
Already a member? Log in here

How do junior doctors spend their time in an Acute Medical Unit? Read More

Shopping Basket
Scroll to Top

Start typing and press enter to search

Start typing and press enter to search