Viewpoint

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Summary Care Records in Urgent and Emergency Care in England

Viewpoint, Volume 12, Issue 3, Pages 125 - 184 (2013)

Abstract

Summary Care Records (SCRs) have been created for more than 50% of the population of England. The number is increasing at about 100,000 records a week. Fewer than 1.5% of people have elected not to have a SCR. SCRs contain updated details of patient medication, allergies and adverse reactions, electronically extracted from the GP record. A patient and their GP can also agree to have additional information included. SCRs are being viewed by authorised healthcare staff in urgent and emergency care settings all over England. Benefits are being reported in relation to increased patient safety, improved clinical decision making, improved efficiency and improved quality of care. NHS England strongly supports the uptake and adoption of SCRs by Trusts in England.

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Is there a role for a diabetes specialist on the AMU?

Viewpoint, Volume 12, Issue 1, Pages 1 - 64 (2013)

Many specialists have taken time to adjust to the development of acute medicine and Acute Medical Units (AMUs). As these concepts have evolved, so has the understanding of how specialists can better interact with their new acute medicine colleagues and how they help to ensure the smooth running of one of the most vital cogs of the hospital ‘machine’. For some specialties (Cardiology , Respiratory Medicine etc), it has been relatively straightforward to integrate into the new model - perhaps due to the sheer numbers of acute patients relevant to those specialties. However, for the chronic disease specialties such as diabetes, it has been less easy to understand how to optimize the interface with acute medicine.

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British Society of Echocardiography Accreditation – The ‘Gold Standard’ For Acute Medicine

Viewpoint, Volume 7, Issue 3, Pages 105 - 150 (2008)

We read with interest to the article written by Kevin Fox 1 and wholly support the notion that acute medical trainees who wish to undertaken echocardiography within the medical admissions unit (MAU) should achieve British Society of Echocardiography (BSE) accreditation. I was one of the first trainees in acute medicine to undertake training in echocardiography; despite considerable competition from cardiology registrars as well as resistance from the physiology department I am now close to attaining the BSE Trans Thoracic Echocardiography accreditation.

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A Position Statement: Echocardiography in the Critically Ill

Viewpoint, Volume 7, Issue 2, Pages 61 - 104 (2008)

Numerous studies have demonstrated the value of echocardiography in the assessment of critically ill patients in the Intensive Care Unit (ICU) and Emergency Room (ER). We seek to encourage expansion of echocardiography in these areas. However it is important to establish training programmes, standards of knowledge and skills, assessment methods and quality assurance if echocardiography is to be offered with confidence in these clinical areas. We have undertaken discussion with the many groups with a relevant interest in critical echocardiography and developed a consensus on proposals for the appropriate provision of training in echocardiography for the ICU, ER, and increasingly the medical high dependency and admissions wards.

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Basic ultrasound skills should be a core component of training in the acute medicine curriculum

Viewpoint, Volume 7, Issue 2, Pages 61 - 104 (2008)

6.30 pm Friday, and you are doing the afternoon intake round. A 33-year-old African woman presents with 2 months malaise, cough and dyspnoea. Her CXR shows an enlarged globular heart. HIV and TB are your first thoughts, but do you need to call in the cardiologist?

11 am Saturday on the Acute Medical Unit (AMU). A 35 year old man has been seen earlier this morning following a collapse, after being assaulted 2 days previously; the diagnosis is unclear. You spot him looking pale and tachycardic. Further examination shows bruising in the flanks. Is he bleeding internally?

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Bedside ultrasound in the Acute Medical setting – Practiced by the Acute Physician or Ultrasonographer?

Viewpoint, Volume 7, Issue 2, Pages 61 - 104 (2008)

Ultrasound is widely used by physicians in the emergency medical setting in the USA, Australia and Europe. The objective in bringing ultrasound to the bedside is to bring immediacy to diagnostic decisions and improve safety for interventional procedures. Additionally within the NHS there are increasing pressures to limit bed usage and manage more conditions in an ambulatory setting. Shortening the time to scan and decisions based on the results would be of benefit to the individual patient and the organisation.

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Acute Medicine and Emergency Medicine are not (Yet?) The Same

Viewpoint, Volume 7, Issue 1, Pages 1 - 60 (2008)

The acquisition of “Level 3” competencies in the setting of the Emergency Room from StR in Acute Medicine raises the question of the boundaries and competences of Acute Medicine and Emergency Medicine. The possibility that phisycians with a training both in Emergency Medicine and Acute Medicine will be involved in the management of Emergency Admission Units and Emergency Medicine Departments in the future is herein considered.

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A Response to the Viewpoint Paper in Vol 6 issue 2

Viewpoint, Volume 6, Issue 3, Pages 93 - 136 (2007)

We read with interest the “viewpoint” by Sarbjit Clare and colleagues recommending that specialist registrars in acute medicine should receive patients in the resuscitation room.1 We agree that this is a valuable training experience, but question some of the assumptions made.

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Specialist Registrars in Acute Medicine Receiving Patients in the Resuscitation Room: A Key Component in the Training Curriculum

Viewpoint, Volume 6, Issue 2, Pages 49 - 92 (2007)

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.

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Acute Abdominal Pain for the General Physician – who, when and how to refer to the on-call surgeon

Viewpoint, Volume 4, Issue 1, Pages 1 - 44 (2005)

Abstract

Patients with abdominal pain are most frequently referred to the on-call surgical team, but there are occasions when physicians may be required to assess, investigate or treat such patients. This article aims to equip non-surgeons with the skills to undertake an appropriate initial assessment and consider the most appropriate selection, timing and mode of referral to the surgical team.

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