Acute Medicine Journal

18/07/2023

🔬 New research highlights the increasing number of ED visits by older patients in the Netherlands, despite a decrease in total ED visits. From 2016-2019, there was a surge in ED visits by those aged 70+, with or without admission. However, this slight rise in older patients is in line with the overall increase in the elderly population in the country. It seems that crowding in Dutch EDs can't simply be attributed to the numbers of older patients alone. As we explore the complex issues of ED crowding, this study suggests a need for further research into other contributing factors, like the complexity of care needs within the ageing population. Check out the study for more details ➡️

https://ow.ly/Yckp50PeVBr

14/06/2023

📣 The latest issue of the Acute Medicine Journal is now available online. Packed with cutting-edge research, insightful case studies, and expert commentary, Volume 22 Issue 2 is a must-read for all healthcare professionals in the field of acute medicine. 🩺🔬 Dive in to enrich your knowledge and stay ahead in your practice. Check it out here 👉 https://ow.ly/LJ1J50OO0Mu Don't forget to share with your peers!

27/03/2023

Clinical decision-making is a core skill for the practice of medicine, and yet, during training, there is often little formal analysis of the process of clinical reasoning or instruction about how to do it better.
This paper reviews the process of clinical decision-making with a particular focus on diagnostic reasoning. Aspects of psychology and philosophy are applied to the process along with consideration of potential sources of error and the steps that can be taken to minimize this.

http://ow.ly/Jlki50NsVNj

19/08/2018

Point of care ultrasound (POCUS) has seen steady growth in its use and applications in aiding clinicians in the management of acutely unwell patients. Focused Acute Medicine Ultrasound (FAMUS) is the standard created specifically for Acute Medicine physicians and is endorsed by the Society for Acute Medicine and recognised by the Acute Internal Medicine (AIM) training committee as a specialist skill.

Abstract Point of care ultrasound (POCUS) has seen steady growth in its use and applications in aiding clinicians in the management of acutely unwell patients. Focused Acute Medicine Ultrasound (FAMUS) is the standard created specifically for Acute Medicine physicians and is endorsed by the Society....

19/08/2018

No reported cases to date describe herpes simplex virus (HSV) myelitis in association with cancer and chemo-radiation. We report a case of sub-acute HSV myelitis in a 54-year-old man receiving chemo-radiation with 5-flourouracil for esophageal cancer who presented to the emergency department with increasing numbness in both lower limbs that gradually…

Abstract No reported cases to date describe herpes simplex virus (HSV) myelitis in association with cancer and chemo-radiation. We report a case of sub-acute HSV myelitis in a 54-year-old man receiving chemo-radiation with 5-flourouracil for esophageal cancer who presented to the emergency departmen...

19/08/2018

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of neck or back…

A 51-year-old lady, with a background of an arachnoid cyst and ventriculo-peritoneal shunt in situ, presented to the Acute Medical Unit with a 2-day history of neck pain. She awoke from sleep with the pain and it persisted since. She had not been involved in any trauma, had no previous history of ne...

19/08/2018

Acute ambulatory care is a critical component of the emergency care pathway with national policy support and a dedicated NHS Improvement network. The evidence base for treating acute medical illness outside hospital is a diverse mix of randomised and observational studies with varying inclusion criteria, prognostic stratification, interventions and healthcare setting which limits synthesis of all available evidence and translation to the UK context. There is little consensus on the level of risk for home-based treatment for acute medical illness. Selection tools for referral to acute ambulatory care have been developed but there is limited evidence for their use. There are still research questions concerning optimal staffing, referral mechanisms, point of care diagnostic portfolio and tools for shared decision making.

Abstract Acute ambulatory care is a critical component of the emergency care pathway with national policy support and a dedicated NHS Improvement network. The evidence base for treating acute medical illness outside hospital is a diverse mix of randomised and observational studies with varying inclu...

16/08/2018

SOCIETY FOR ACUTE MEDICINE AUTUMN MEETING OCTOBER 3RD /4TH
The regular autumn meeting of the society for acute medicine was hosted this year by Dr Martin Culshaw at Queen ’s Medical Centre in Nottingham. As in previous years, the meeting was spread over two days with the conference dinner at the Nottingham Hilton hotel on the evening between. This was Derek Bell ’s last meeting as President of the society, and in taking over the helm, Paul Jenkins paid tribute to his achievements over the past three years during the after dinner speeches. Emergency Care Tsar, Professor Sir George Alberti, opened the meeting with an enlightened view of the current, and future state of emergency care in the UK. Entitled ‘Emergency Care – nightmare or sweet dreams’ ,he left us in no doubt that the high profile of ‘front-door ’medicine would continue over the next few decades. Derek Bell followed, in his role as clinical lead of the Emergency Services Collaborative, with a summary of the achievements of the Collaborative to date. (To read more please click on the link below)

https://acutemedjournal.co.uk/journal/volume-2/volume-2-issue-3-pages-75-107-2003/society-for-acute-medicine-autumn-meeting-october-3rd-4th/

The regular autumn meeting of the society for acute medicine was hosted this year by Dr Martin Culshaw at Queen ’s Medical Centre in Nottingham. As in previous years, the meeting was spread over two days with the conference dinner at the Nottingham Hilton hotel on the evening between. This

26/07/2018

A NON-CARDIAC CAUSE OF AN ABNORMAL ECG
Abstract
Abnormalities of the electrocardiogram are extremely useful for the diagnosis of heart disease, but they may also occur in non-cardiac conditions. The electrocardiographic abnormalities that have been described in neurological diseases are among the most striking deviations from normal. We describe a patient with an intracranial space occupying lesion... (To read more please click on the link below)

https://acutemedjournal.co.uk/case-reports/a-non-cardiac-cause-of-an-abnormal-ecg/

26/07/2018

BRITISH SOCIETY OF ECHOCARDIOGRAPHY ACCREDITATION – THE ‘GOLD STANDARD’ FOR ACUTE MEDICINE
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 read more please click on the link below)

https://acutemedjournal.co.uk/viewpoint/british-society-of-echocardiography-accreditation-the-gold-standard-for-acute-medicine/

26/07/2018

PICTURE QUIZ: ABDOMINAL PAIN IN A PATIENT RECEIVING LOW MOLECULAR WEIGHT HEPARIN
A 63 year old lady with known ischaemic heart disease was admitted to hospital with cardiac sounding chest pain. Blood pressure was 161/80 on admission, and full examination was unremarkable. ECG showed ischaemic changes in the inferior leads, and a diagnosis of unstable angina was made. Troponin I was undetectable. She was treated with subcutaneous Enoxaparin 1.5mg/kg and an intravenous nitrate infusion. Her pain settled the... (To read more please click on the link below)

https://acutemedjournal.co.uk/picture-quiz/picture-quiz-abdominal-pain-in-a-patient-receiving-low-molecular-weight-heparin/

02/10/2017

Let's talk about s*x in a guide to taking s*xual history for Acute Physicians

Introduction It’s a Monday morning; the week-end has seen the re-admission of a retired teacher with a dry cough, increasing dyspnoea and no physical signs. His chest X-ray ten days previously didn’t show any abnormalities. The course of amoxicillin given by his GP has not helped. He has an oxygen s...

01/10/2017

Creutzfeldt-Jakob disease (CJD) is a rare prion disease classically manifesting with rapidly progressive dementia, abnormal movements and typical electroencephalographic (EEG) changes. Case Report: A 74 year-old Caucasian man was recently discharged from another centre diagnosed with a stroke. He re-presented to our acute medical unit with worsening symptoms, and stroke…

29/09/2017

Late HIV diagnosis is the most important predictor of HIV-related morbidity and mortality in the UK and often results from missed testing opportunities during earlier contact with health services. The HPA now recommends routine HIV testing be commissioned as a priority for all general medical admissions in high prevalence areas, such as…

27/09/2017

The transition from registrar to consultant in medicine is one that trainees feel ill prepared for and can be extremely stressful. We devised the concept of an Acute Medicine “Finishing School” for senior trainees in London training programmes and ran sessions on CV writing, a simulated consultant interview, consultant job planning, responding to complaints and an out of hospital emergency scenario...

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26/09/2017

When I first saw the title of this book, my initial assumption was that it was a training ‘guidebook’ – one of those texts which aims to help trainees to navigate their way through the treacherous waters of work-life balance...

Have you read this text? What was your initial thoughts?