Category: Medical

Mpox (Formerly: Monkeypox)

Wear Gloves & Wash Your Hands!!!

There have been >100 patients identified as having Mpox in the UK during the current outbreak. Most of these cases have been amongst men who have sex with men.

Reports have suggested that although lesions occur any where including palms and soles. Genital lessons and lymphadenopathy are very common

March 2024 – UKHSA warn there is increasing cases in DRC (Democratic Republic of Congo), so stay vigilant in travellers from central Africa.

 

Trust SOP -HERE

Read more

DKA – Adult

Things to remember

  • Give 0.9%NaCl
  • Actrapid “Fixed Rate” 0.1unit/kg/hr
  • Basal Insulin e.g. Levemir, Lantus, Semglee, Abasaglar, Toujeo, Tresiba,
    please continue this at usual dose and times
  • Potassium – if below 5.5 will need KCl infusion (see guide)
  • BM <14 – Start 10% Dextrose 125ml/hr
  • BEWARE SGLT-2 inhibitors chance of Euglycaemic DKA

Read more

Unsuspected NoF

We have seen multiple incidence where clinicians of ALL grades have assessed patients with falls and examined hips and even mobilised patients

Evidence shows (and reflected in the incidents) this predominantly effects patients with:

  • Communication difficulties: inc. Delirium, dementia, learning difficulties
  • Live in Supported accommodation
  • Normally require help mobilising

If a patient presents with ANY of these and a fall – X-ray Pelvis

 

Measles

Suspected/Confirmed patients should be ISOLATED & wear PPE 

Treating Staff – (should not be; non-immunised, pregnant or immunocompromised)

  • single-use, disposable gloves
  • single-use, disposable apron (or gown if extensive splashing or spraying, or performing an aerosol generating procedure (AGP))
  • FFP3 – respiratory protective equipment (RPE)
  • eye/face protection (goggles or visor)

Patient

  • Surgical face mask

Background

  • Measles is highly infectious – (4 day prior to and after rash appears) suspected patients should be isolated within the ED
  • Measles Immunisation – 1 dose 90% effective, 2 doses 95% effective
  • Measles is a notifiable disease
EM3

Read more

Medical SDEC

Note: If the referrer feels the presentation of a patient is not within the inclusion/exclusion criteria they can still contact the SDEC co-ordinator and check for acceptance into SDEC.

  • ED referrals ONLY 08-18:00
  • Check Capacity prior to sending
  • Investigations: FBC/U&E/Clotting/ECG

Read more

LVAD – Resus & Troubleshooting

ctsurgerypatients.org

LVADs (Left Ventricular Assist Device) are becoming more common and there are patients in our region with them as a bridge to transplant or recovery and in some cases a destination therapy.

The patient and their family will likely know more about this device than you and should have brought spare parts. Our local LVAD centre is Wythenshaw however, there are other units around the country the patient may direct you to.

The patient may not have a palpable pulse, the blood pressure will be low and the heart pump sounds like a buzz when you listen.

If patient is unresponsive or has a history of collapse its important to troubleshoot the device and resusitation may be required

Read more