Author: embeds

July 17, 2020

Covid-19 (Hyperglycaemia)

Both COVID-19 infection and treatment with dexamethasone impair glycemic control. So its important to monitor blood sugars and consider DKA & HHS in COVID-19 patients. Latest guidance from DIABETES-UK

GLUCOSE MONITORING

Target glucose 6.0 -10.0 mmol/L (up to 12.0 mmol/L is acceptable)

June 14, 2020

Paediatric – Time Critical Transfers (non-trauma)

Definition of a time critical transfer

Transfer of a patient for life, limb or organ saving treatment when the time taken to provide this treatment is a critical factor in outcome.

Principles

Acceptance by the regional centre is NOT dependent on bed availability.
Time critical transfer should normally be provided by the referring hospital team NOT Embrace.

June 13, 2020

AKI – Acute Kidney Injury

AKI is a common issue for patients presenting to the ED and not only has a significant mortality associated with it but also a massive cost to the NHS. Early recognition and treatment can improve outcomes. Read more

June 12, 2020

AKI – teaching

Since we need to keep socially distanced, teaching may need to be a bit different. so this is our first effort to provide you with some local teaching resources.

Watch the video

Teams Q&A

we will send out invites to a teams meeting so we can discuss pointss around the teaching – and if we have time any other issues

Reference material

June 10, 2020

Limping Child

This is a relatively common presentation within the ED that has a myriad of possible diagnoses ranging from sprain to malignancy. One thing to remember is that patients and relatives will look for a traumatic reason for limb pain, and may link it to minor injuries that would not have caused it. Read more

June 10, 2020

Hypercalcaemia

90% of hypercalcaemia is due to either malignancy or hyperparathyroid.

Severity: Adjusted Calcium (Ca)

Severe: >3.5mmol/l – URGENT treatment (risk of dysrhythmia)
Moderate: 3.0-3.5mmol/l – PROMPT treatment (maybe well tolerated if chromic)
Mild: <3.0mmol/l – doesn’t require urgent treatment and often asymptomatic

June 10, 2020

Bell’s Palsy

Bell’s Plays is a lower motor neurone (LMN) lesion of the facial nerve (CN VII), which causes one side of the face to “droop” [1% of cases are bilateral], and patients are often concerned that it is a stroke.

However, unlike in stroke the whole face is affected, in stroke and other upper motor neurone (UMN) lesions the upper portion of the face is unaffected due to input from both sides of the brain. Read more

June 10, 2020

Hypokalaemia

Hypokalaemia (low potassium), is a common problem. It is found in 14% of outpatients and 20% of inpatients, however only 4-5% of those are of clinical significance.