Category: Abnormal Observations

Hypoglycaemia

Management of low blood sugar in conscious & unconscious patients, finding common causes, adjusting medications & when to refer.

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Fluid Balance

Almost every patient admitted to hospital receives IV fluids at some point in their journey. However, the body manages this, without the need for careful medical assessment and adjustment, as fluid balance is one of its core functions. Despite this, there are many situations where we need careful and controlled management. These include: Electrolyte disturbance

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Hypothermia

Hypothermia, whilst an infrequently encountered issue during foundation, is a high-risk condition with a need for investigation and often rapid intervention. It is defined as a core body temperature less than 35°C and can be divided into mild, moderate and severe (by the extent of hypothermia and associated signs/symptoms) or into the duration of onset

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Hyperglycaemia

Hyperglycaemia is something you will encounter frequently. In this article, we focus on how to approach hyperglycaemia and identify diabetic emergencies. If your patient is ketotic or has significant hyperglycaemia (>30mmol/L), consider DKA or HHS respectively which are covered in a separate article. Introduction Hyperglycaemia may be the first indication that a patient is unwell.

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Hypertension in Hospital

As a junior doctor, you will often be called about patients with raised blood pressure (BP) in secondary care. This differs from chronic hypertension in primary care for which the treatment is summarised expertly by NICE. Here we look at the assessment and management of hypertension in acute care, with a focus on hypertensive emergencies

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Reduced GCS

As a doctor, you will frequently be called for a drowsy patient. They can vary from confused to completely unconscious. The Glasgow Coma Scale can help reliably quantify and track the level of consciousness over time – however, during the initial assessment, it takes too long unless you use it regularly. You can use AVPU

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Hypotension

Expect many bleeps about hypotension from concerned nursing staff. It is a useful way to flag up which patients might be unwell. Although defined as below 90 systolic or 60 diastolic, we usually most heavily rely on the systolic on the wards. The concern is shock – hypotension that leads to hypo-perfusion of organs/tissues resulting

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Hypoxia

As an FY1, you will be called to review hypoxic ward patients. Here we discuss common causes of generalised hypoxia and not focal hypoxia/ischaemia such as in a stroke or heart attack. Insufficient oxygen-carrying capacity due to anaemia, or ineffective use of oxygen at the tissue level (no cyanide management here zebra hunters!) will also

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Deteriorating Patient

The deteriorating patient is often the worst nightmare for new FY1s.  I remember when I started FY1, I was terrified of coming across a deteriorating patient whilst on call and having to manage them all alone. However, it is important to remember that although you will definitely come across deteriorating patients, help will always be

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