Categories
Gastroenterology Medicine

Decompensated Liver Disease and Cirrhosis

Decompensated liver disease and cirrhosis are common pathological states present on the gastroenterology ward. It is important to understand the basic principles of management and aetiology as a junior doctor in these complex and unwell patients. Dr Liz Sweeney is a specialist hepatology registrar at the Royal Liverpool Hospital. In this episode, she talks to […]

Categories
Gastroenterology Medicine

Acute Alcohol Withdrawal and Alcoholic Hepatitis

Acute alcohol withdrawal and alcoholic hepatitis are common scenarios presenting to the Emergency Department (ED) and the ward. Recognition, investigation and management principles are imperative to prevent serious complications. Dr Liz Sweeney is a specialist hepatology registrar at the Royal Liverpool Hospital. In this episode, she talks to us about acute alcohol withdrawal and alcoholic […]

Categories
Cardiology Medicine

Atrial Fibrillation

Atrial Fibrillation is the most common arrhythmia (1, 2) and it can often feel like an on call shift is dominated by patients with AF when it is not controlled. Patients with AF present to Emergency Departments and acute medical takes frequently and it complicates many surgical patient admissions too. On the face of it, […]

Categories
Medicine Renal

Acute Kidney Injury – Part 2

Acute Kidney Injury (AKI) is a disease process that carries a significant mortality impact (1). The complications that accompany AKI can be difficult to manage and may require specialist input if resistant to treatment. The management of AKI also changes when faced with some special situations. Dr Aled Lewis is a Consultant Nephrologist at Glan […]

Categories
Renal

Acute Kidney Injury – Part 1

Acute Kidney Injury (AKI) is not only common but has an enormous impact upon patients. Length of stay in hospital can be increased alongside increases in mortality (1). This effect on in-hospital mortality has attracted significant attention from the media in recent years (2). Increasingly, hospital blood reporting software includes AKI alerts based upon creatinine […]

Categories
Diabetes/Endocrine

Diabetes and Peri-Operative Care

“How do I manage a patient with diabetes who is going for surgery? Should I start a variable rate intravenous insulin infusion? When should I resume their metformin?” For the answer to all these questions and more, check out our latest FOAMdation podcast and blog. Listen below: iTunes Podbean (non-iPhone) Dr David Ewins is a […]

Categories
Elderly Care

Falls

Over 280 000 falls occur in acute, community and mental health hospitals across England and Wales each year (1). Falls can increase the length of stay and prevent patients from returning to independent living and at worst result in severe injuries and death (1, 2).   Dr Josh Deb-Barman is a speciality doctor in Elderly Care […]

Categories
Acute Care Diabetes/Endocrine

Hyperglycaemia in hospital and Variable Rate Intravenous Insulin Infusion (VRIII)

Diabetes is an increasing worldwide problem, with approximately a fourfold increase in prevalence over a thirty-year period in the latest World Health Organisation figures (1). Dr David Ewins is a Consultant Physician in Endocrinology and Diabetes and talks with Scott about the approach to evaluating and managing adult patients presenting with high blood glucose levels […]

Categories
Acute Care

Metabolic Acidosis

You are the medical FY2 doctor on call and a GP referral has just arrived in the Medical Assessment Unit (MAU). You are told the patient has been vomiting for 2 days with associated polyuria and polydipsia, they are tachycardic but have a stable blood pressure. The nurse is worried and the patient looks sick. The nurse […]

Categories
Acute Care Diabetes/Endocrine

Diabetic Ketoacidosis in Adults

Diabetic Ketoacidosis (DKA) is a life threatening emegency and requires prompt recognition and treatment. Dr David Ewins is a Consultant Physician in Endocrinology and Diabetes and talks with Scott about the approach to evaluating and managing DKA in adults as well as some of the finer points and controversies that exist. Have a listen to the episode below or […]

Categories
Elderly Care Pharmacy

Polypharmacy

  I talk with Dr Lishan Liu, an Elderly Care Medicine Registrar at Chester, about Polypharmacy in the older patient. Lishan has previously undertaken work investigating Polypharmacy and Potentially Inappropriate Medications (PIM) amongst patients on Elderly Care wards and the application of a tool to help with improving prescribing. Whatever speciality you work in, with the […]

Categories
Acute Care Cardiology

Acute Coronary Syndromes

Scott talks to Consultant Cardiologists Professor John Somauroo and Dr. Babu Kunadian and Karen Randles, a cardiology specialist nurse at Chester about the assessment of patients presenting with chest pain and the management of Acute Coronary Syndromes (ACS). This includes ST-segment-elevation myocardial infarctions (STEMI) and non-ST-segment elevation myocardial infarctions (NSTEMI). Check out the podcast below or […]