Category: Medicine

Haematological emergencies

In this article, we give an overview of the most important and serious haematological emergencies that junior doctors should know about! Neutropenic sepsis Case 1: 54-year-old woman Recent new diagnosis of a high-grade lymphoma Received R-CHOP chemotherapy 7 days ago Presents to ED with a fever of 38c What could be going on here? What

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Skin Cancer

Skin cancers have one of the highest global incidences of any type of cancer. Early diagnosis and management of melanoma can be life-saving. Junior doctors are in a position to spot such lesions and it is therefore important to be able to recognise them. The different types of skin cancer can usually be identified clinically,

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Bradyarrhythmias

Bradyarrhythmias are abnormal heart rhythms with a pulse rate of <60 beats per minute (bpm). This can be due to a variety of causes, including sinus node disease, atrioventricular disease, or toxins. Although the definition of bradyarrhythmia (brady- = slow, arrhythmia = abnormal rhythm) is defined as a heart rate (HR) <60bpm, many patients remain

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Hypoglycaemia

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

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Hypercalcaemia

Serum calcium concentration is tightly regulated between 2.1-2.6mmol/L. Severe hypercalcaemia is a life-threatening electrolyte emergency requiring prompt recognition and urgent treatment.   Classification Mild (2.65 – 3.00 mmol/L): Patient is often asymptomatic Moderate (3.01-3.40 mmol/L): Can be asymptomatic or symptomatic Severe (>3.40 mmol/L): Risk of dysrhythmia and coma Serum calcium is found in 2 forms

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Reporting Adverse Drug Reactions

The World Health Organization (WHO) defines adverse drug reactions (ADR) as “any response to a drug which is noxious and unintended, and which occurs at doses normally used in man”. Importantly, these refer to situations when the drug is used normally and at the recommended dosages. ADRs may be classified into six categories, based on

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PICC Lines and Midlines

You may well be asked to take blood from a PICC line or be called to see a patient because their PICC line is not working. In this article we will take you through the basics of PICC lines, why they are needed, how to use them and some common pitfalls. Please note that procedures

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ECG Basics

The electrocardiogram (ECG) is one of the most common, and important, investigations interpreted by doctors. In order to help the interpretation process, it is necessary to understand the physiology behind the ECG. In this article, we will explore the basics of ECG physiology, and build on this knowledge for interpretation in later articles. In a

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Pneumothorax

A pneumothorax is defined as the abnormal collection of air between the visceral and parietal space of the lung i.e. the pleural space. It typically presents with acute shortness of breath, pleuritic chest pain and is more common in those with damaged or stretched lungs. Despite clear cut guidelines from BTS, real-life management varies considerably

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Superior Vena Cava Syndrome

SVC syndrome is an oncological emergency. There is obstruction of the superior vena cava resulting in stagnating blood and a high risk of thrombosis. Due to this obstruction, collaterals develop to drain the head, neck & upper extremities which dilate over several weeks. Cardiac output is usually not severely diminished as the quick rise in

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