As we look forward to the warmer months. Last year saw a dramatic rise in the number of training posts in Acute Medicine, a trend which will continue this August. The Department of Health considers Acute Medicine to be one of the few hospital specialities with the potential for future expansion, and additional funded NTNs […]
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.
1st Prize: What is the effect of a consultant presence in an Acute Medical Unit?
Poster Prize Winners Read More
The Scottish Exhibition and Conference Centre provided the venue for the first truly International meeting of the Society for Acute Medicine in early October. Almost 600 delegates were treated to some unseasonal Glasgow sunshine and traditional Scottish hospitality, as they enjoyed the varied programme put together by Mike Jones, Derek Bell and Liz Myers. The long distance that the Society has travelled in the past 7 years to reach this size was emphasised repeatedly over the two days; in his inaugural address to the society as incoming President, Dr Rhid Dowdle told us that SAM is now playing in a much bigger league than ever before, but cautioned that the speciality still has a way to go to reach the ‘top division’. Some of the highlights of the meeting are summarised below, but for those delegates who did not make it to the event most of the presentations are now available on the SAM website (www.acutemedicine.org.uk)
Setting New Standards for Acute Care Read More
Well that’s it from me! At the close of our 1st International meeting in Glasgow I handed the reins of Presidency to the safe hands of Rhid Dowdle.
The President’s Piece: A Final Word Read More
A key component of training in Acute Medicine is the assessment and initial resuscitation of severely ill medical patients. The curriculum for General Internal Medicine (Acute Medicine) states that all specialists in Acute Medicine should attain Level 3 competencies in all emergency presentations.1 Different training programmes have variable exposure to the emergency department, to which the majority of these patients present. One module, currently being developed at City Hospital, Birmingham, is for the Acute Medicine Specialist Registrars (SpRs) to attend all medical alerts in Accident and Emergency (A&E) Department. This means that the SpR works as part of the receiving team, seeing patients first hand, rather than taking secondary referrals. At our hospital over 80% of alerts brought in the resuscitation room are medical emergencies.
Abstract
Venous thromboembolism has long been recognised as a potentially avoidable cause of significant morbidity and mortality in hospitalised patients. With national recommendations awaited there have been clear instructions from the department of health that steps need to be made at a local level to increase awareness and address the problem prior to the expected completion of the NICE guidelines in 2007. We demonstrated an improvement in the prescription of thromboprophylaxis following implementation of simple and inexpensive changes in our department.
Improving Local Practice of Venous Thromboembolism Prevention in Medical Patients Read More
A 76-year-old man was admitted to the acute medical take with a long history of tiredness. He described slowed thinking, constipation, aching thighs, dry skin, a hoarse voice, hair loss and 10 kilograms of unintentional weight loss. He had lived in Spain for 7 years and his daughter had persuaded him to return to the UK for a medical check-up.
An Unusual Cause of Pancytopaenia Read More
Abstract
Seizures are a common presenting complaint in acute medicine and post-ictal patients can pose a diagnostic challenge. Approximately 1% of patients presenting after a seizure will have sustained a fracture. Delayed diagnosis is common and can lead to worse functional outcomes. A case of occult bilateral neck of femur fracture secondary to seizure is presented together with a review of the literature.
Occult Bilateral Hip Fracture Secondary to Seizure: A Case Report and Literature Review Read More
A 47 year old Chinese businessman was found unconscious at home following an overdose of 280 mg temazepam. He was found by his sister who had visited because he had not returned her telephone calls for several weeks. He had been resident in England for 8 years but returned to Hong Kong frequently. Since his last visit to Hong Kong, 4 months previously, his mood had been low and he had developed anorexia, weight loss and insomnia. Physical examination and routine investigations were unremarkable and a diagnosis of depression was made. Citalopram 10 mg daily and temazepam 10 mg daily had been prescribed one day prior to admission.
Tuberulous Meningitis masked by Temazepam Overdose Read More