The patient who was forced to play God
— Please consent this patient for thrombolysis following his ischaemic stroke. He is a previously well man in his early 30s accompanied by his wife. He has suddenly lost all…
Has anyone ever lured the on-call surgeon out of the mess?
Apologies for the delay. A mixture of on-calls, time off and working on other medical education projects got in the way. Also, I couldn’t find the ? ST Elevation patient’s…
[Poll 2] STEMI or not? You make the call.
ECG at admission ECG at 12 hours
My answer to the poll. And an apology.
Sorry for the delay. Let’s start by going through the simple intervention that brought down the patient’s EWS from the last post, and then in the next post I’ll talk…
[Poll] Really Unwell Patient #1: Rising RR, rising HR, feeling sweaty. And that’s just you.
This patient was treated with one of the above options and made the remarkable recovery you can see from 1522 to 1637. Can you spot what is unusual about…
Prescribe the damn aspirin. Then think about it.
ACS is not just about sorting out the meds and organise the PCI ASAP, then moving on. If the patient is still alive and sitting front of you following an…
Your first patient has an INR of 10
“Was the INR really 10?” asked the CT2 as we left the handover meeting. “Yeah. It actually said >10 which means its probably 20.” “Or 100” “Or she’s just a…
There are no guidelines on inpatient hyperglycemia
Following on from the COPD blog post, the same patient later had a series of interesting capillary blood glucose levels. Bear in mind he was a known type 2 diabetic…
Hypoxia kills. Hypercapnia happens.
“Steady on his O2 there. He’s a COPD patient; we don’t want him to stop breathing.” A 73 year old man with COPD not on home oxygen and usually well-controlled…
Dont Dimer
“But the d-dimer is 64,954! It has to be a PE!” To paraphrase the BTS: “Only a normal i.e. negative d-dimer is of any clinical value. A positive value, no matter…