Chest Pain, STEMI, NSTEMI and beyond


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 for further information, including references for the information discussed. 

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Speak soon!



Acute pain, managing epidural and the alternative!


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.





Antibiotics plus gentamicin/vancomycin prescribing


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.




Referrals: a primer and troubleshoot


Just Gareth, on his living room floor, musing about his experiences with referrals over the last few years. We do recommend you find your own style to handle referrals but hope this provides the beginnings to developing it and gives you some advice to tackle problems encoutered


Assessment of the unwell patient.mp3


Gareth speak with Dr Sarah White, anaesthetic registrar, about how to assess an acutely unwell patient. The case chosen was deliberately the kind of patient that would make anyone scared in assessing them; they will always have the potential to continue getting worse despite whatever you do and you should always be reassessing the patient to be sure your treatments are effective. At all times remember to ask yourself: do I need help?

There are plenty of resources you can look at to gain a better understanding of this, however one definite one to get your hands on is Essentials of Acute Care 2nd Edition.


Working 9-5.mp3


Gareth introduces Dr Scott Williams, a current ICU clincal fellow andprevious Core Medical Trainee. Together they discuss aspects of life working on a ward that can help junior doctors when working in a wrd environment.

Visit the website for an exmple of a ward list and the "box system" for guiding how completed your jobs are.

Follow us on twitter, like us on Facebook and email with any feedback you have. If you have any suggestions about how to improve the project or any topics you wish to hear covered.


sepsis for Foundation.mp3


Gareth meet Dr Santokh Singh, Consultant Anaesthetist and Intensivist at the Countess of Chester Hopital. Santokh is also the Sepsis lead for the hospital and currently developing new hospital protocols for the dingosis and mngement of sepsis.

The discussion focuses on recent changes to the definitions of sepsis, the use of lactate in sepsis and a way of thinking about the approach to fluid resuscitation of patients with sepsis. The purpose of this episode is to provide basic level advice and guidnce for Foundation Doctors deling with sepsis in the initial stges.

Visit for links to the evidence and guidelines we discussed. Follow us on twitter @foamdation, fnd us on Facebook an email in order to give us any feedback.


Call on me…..mp3


Greth and Scott discuss the things they feel can help Foundation Doctors thrive in an on call shift. If you have any further suggestions about what can help then please get in touch by commenting, visitiing the website, twitter @foamdation or find us on Facebook. You can email us at All feedback is welcome and we would like to hear about things that can help us improve and develop the project.


What the devil is FOAMdation?!


Dr Gareth Thomas describes briefly the reasons why FOAMdation has been established and what it all means.


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