Bowel Obstruction

30Sep

Bowel obstruction is a common surgical presentation and in the presence of ischaemia carries a mortality up to 40%.

What makes the diagnosis? How good are the investigations?

Gareth talks to Miss Nicola Eardley, Consultant General and Colorectal Surgeon at Chester, about the important steps in the diagnosis and management from history and examination to imaging and further management.

Check out the accompanying post for discussion points and references used in producing this episode.

Rate us on iTunes if you liked what you heard and follow us on Twitter @FOAMdation. Please get in touch via www.foamdation.com or email foamdation@gmail.com if you have any comments or suggestions. If you like what you hear then share us so others can get the benefit too!

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Hyperglycaemia and Variable Rate Insulin Infusions (VRIII)

2Sep

Hyperglycaemia within diabetic inpatients can be a common occurence. Unfortunately, the answer often used is one of just giving a bolus of insulin. However, there are better ways to correct this and one such solution might include the use of a Variable Rate Insulin Infusion (VRIII) as a temporary measure whilst you work to correct the underlying issue.

Scott speaks once more to Dr David Ewins, Consultant Physician in Endocrinology and Diabetes, about how to manage hyperglycaemia within the inpatient setting and how to correctly start and discontinue a VRIII.

 

Check out the website www.foamdation.com where you can get in touch via the contact button.

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Please rate us on iTunes in order to help others find this resource or share us to anyone you think would benefit!

 

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Metabolic Acidosis

18Aug

Metabolic Acdisosis is the herald of badness occurring within our patients and can be due to either endogenous or exogenous acids. What we really want is a system to use at the bedside when faced with acidosis so we can tailor our treatments based on what the patient needs.

Gareth speak with Dr Simon Ridler, Consultant Anaesthetist and Intensivist at Chester about the approach towards solving metabolic acidosis and interpreting the blood gas like a pro. They also discuss a shortened mnemonic of LURK to help you remember the most likely causes of acidosis in in patients you are likely to encounter on the wards as a junior doctor.

L: lactate

U: unmeasured anions

R: Renal failure

K: Ketoacidosis

 

Check out the website www.foamdation.com where you can get in touch via the contact button.

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Email foamdation@gmail.com if you have any suggestions, corrections or want to be involved.

Please rate us on iTunes in order to help others find this resource or share us to anyone you think would benefit!

 

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How to be a junior doctor part 2

30Jul

Starting out as a junior doctore, fresh from medical school is tough. The challenges are large and the responsibility can seem daunting. Never mind the workload, trying to keep yuorself healthy and maintain a good work-life balance is difficult. But help is at hand! In the second part of this episode, Gareth continues talking with Drs Jack Hannah and Katherine Gillespie about their experiences, how to keep a balance and the advice they have for those coming into medicine from medical school.

 

Check out the post at www.foamdation.com

Follow us on twitter @FOAMdation or search for us on Facebook.

Or email foamdation@gmail.com if you have any comments or suggestions or feel we need to add something to this!

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How to be a junior doctor part 1.mp3

28Jul

Starting out as a junior doctor, fresh from medical school is tough. the challenges are large and the responsibility can seem daunting. fear not! In a two part episode, Gareth talks to Drs Jack Hannah and Katherine Gillespie about their experiences and advice they wish they'd had.

check out the post at www.foamdation.com Follow us on Twitter @FOAMdation Find part 2 coming after this!

Want to add something to this? Email foamdation@gmail.com and we can add what you suggest to this fantastic resource!

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Diabetic Ketoacidosis in Adults

13Jul

Diabetic Ketoacidosis is a life-threatening medical emergency. Prompt recognition and treatment is essential as well as vigilence towards the potential complications.

Dr Davd Ewins is a UK Consultant in Diabetes and Endocrinology at Chester and speak with Scott about DKA from diagnosis to de-escalatino of treatment and some potential pitfalls.

The mainstay of treatment involves a Fixed Rate Intravenous Infusion, IV fluid replacement with potassium replacement, vigilence for hypoglycaemia and identification and treatment of the underlying cause.

When treated effectively, it can be a satisfying condition to treat with patients making a recovery usually within 24 hours.

Please rate us on iTunes

Visit www.foamdation.com for a more in depth discussion and links to any references used to inform our discussion.

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Speak soon!

 

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Polypharmacy/Inappropriate Medications in the Elderly, how to review medications

1Jul

Gareth speaks with Dr Lishan Liu, an Elderly Care Medicine Registar at Chester about what polypharmacy is, the impact it may have on patients and what tools are available to identify polypharmacy and inappropriate medications and how to conduct a medication review.

A run down of the Beer's criteria and STOPP/START criteria can be found at the website along with links to supporting evidence. 

 

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Speak soon!

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Chest Pain, STEMI, NSTEMI and beyond

19Jun

Scott Williams meets with Prof John Somauroo, Dr Babu Kunadian, Consultant Cardiologists and Karen Randles, Specialist Cardiac Nurse, from the Cardiology department at Chester.

 

The topic for discussion is Chest Pain. Chest pain can be encountered in the ED and on the wards so understanding how to approach the patient is important. They talk through the ECG criteria used in the UK for both STEMI and NSTEMI diagnosis, the treatment of both and the further, ongoing investigation and management of ACS within a hospital setting. 

Check out www.foamdaton.com for further information, including references for the information discussed. 

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Get in touch if there is anything you want us to cover in the future or any comments you might have!

Speak soon!

 

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Acute pain, managing epidural and the alternative!

7May

Gareth talks to Dr Dominic Cliff, Consultant Anaesthetist with a special interest in acute pain.

Dominic talks us through the systematic approach towards acute pain and the various targets for our therapy. He also highlights some potential problems with epidurals on the wards and how you can deal with them without turning off the epidural pump! Finally, he outlines Rectus Sheath Catheters, a novel approach towards post-operative pain relief that eliminates the complications of epidurals.

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@FOAMdation

 

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Antibiotics plus gentamicin/vancomycin prescribing

21Apr

Gareth discusses aspects of starting antibiotics and focussing them in line with principles of antibiotic stewardship with Joy Nicholls, an Antibiotic Specialist Pharmacist at Chester Hospital. also up for discussion are the particulars of prescribing Gentamicin and Vancomycin and how to manage the ongoing treatment and when to take serum drug levels.

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@garEMlyn

foamdation@gmail.com

www.foamdation.com

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