Useful review on EM cases
https://emergencymedicinecases.com/episode-16-acute-monoarthritis/
What's in a raised troponin?
A few useful definitions and papers following on from this morning's discussion
ESC guidelines
BMJ summary of approach from 2016
ESC guidelines
BMJ summary of approach from 2016
Endoscopy guidelines - HIQA
Colonoscopy guidelines here:
https://www.hiqa.ie/sites/default/files/2017-01/HIQA-Lower-GI-for-consultation.pdf
The referral theresholds are on page 24
Upper GI endcoscopy here:
https://www.hiqa.ie/sites/default/files/2017-01/Upper-GI-Symptoms-Post-Comms.pdf
Referral thresholds on page 26
https://www.hiqa.ie/sites/default/files/2017-01/HIQA-Lower-GI-for-consultation.pdf
The referral theresholds are on page 24
Upper GI endcoscopy here:
https://www.hiqa.ie/sites/default/files/2017-01/Upper-GI-Symptoms-Post-Comms.pdf
Referral thresholds on page 26
TIA guidelines
The national TIA guidelines can be found here:
https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/acute-management-of-tia-care-bundle.pdf
And the NICE pathway here
https://pathways.nice.org.uk/pathways/stroke/transient-ischaemic-attack
Here's a short paper on general approach
https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/issues/articles/media_a36c413_566.pdf
https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/acute-management-of-tia-care-bundle.pdf
And the NICE pathway here
https://pathways.nice.org.uk/pathways/stroke/transient-ischaemic-attack
Here's a short paper on general approach
https://mdedge-files-live.s3.us-east-2.amazonaws.com/files/s3fs-public/issues/articles/media_a36c413_566.pdf
Neuroopthalmologic emergencies
Good review on the topic here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4572383/
And a cautionary tale if you think ESR and CRP rule out GCA:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770078/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4572383/
And a cautionary tale if you think ESR and CRP rule out GCA:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770078/
Approach to vertigo
Interesting paper on the clinical approach to vertigo
TiTrATE approach Newman-Toker et al
And the same applied to the dreaded posterior circulation infarct
Diagnosing stroke in acute dizziness and vertigo Tehrani et al
Most interesting in the latter is the limited utility of imaging, even DWI-MRI
Could discuss this at a later date for incorporation into Entrypoint
TiTrATE approach Newman-Toker et al
And the same applied to the dreaded posterior circulation infarct
Diagnosing stroke in acute dizziness and vertigo Tehrani et al
Most interesting in the latter is the limited utility of imaging, even DWI-MRI
Could discuss this at a later date for incorporation into Entrypoint
Undifferentiated shock and ultrasound
This is what we were watching the other day
And this is the protocol you use
Sepsis management
See below reading for Emmett's teaching on 6/11/18
BMJ best practice on sepsis
NICE guidelines
BMJ review on steroids in sepsis
Sepsis 3.0 definitions
Brief review of ProCESS, ARISE, and ProMISe
The latest on qSOFA
Some myths (maybe, judge for yourselves)
Enjoy
BMJ best practice on sepsis
NICE guidelines
BMJ review on steroids in sepsis
Sepsis 3.0 definitions
Brief review of ProCESS, ARISE, and ProMISe
The latest on qSOFA
Some myths (maybe, judge for yourselves)
Enjoy
Anaphylaxis
Please see below the suggested reading for the teaching session on anaphylaxis this Tuesday.
WAO 2011 guidelines
EAACI food allergy guidelines
NICE guideline 2011
WAO 2011 guidelines
EAACI food allergy guidelines
NICE guideline 2011
New venue
From now on, teaching will take place in the CSI, room 2001, at 0800 on Tuesdays. The format (half hour case, half hour topic) continues as before.
Early arthritis
Thanks to Padraic for his case presentation on early arthritis this morning.
Please find some links on the topic below
Uptodate review of early arthritis
ACR/EULAR RA classification criteria
Clinical utility of ACPA
EULAR guidelines on management of early arthritis
Enjoy, M
Please find some links on the topic below
Uptodate review of early arthritis
ACR/EULAR RA classification criteria
Clinical utility of ACPA
EULAR guidelines on management of early arthritis
Enjoy, M
Welcome / Introduction / Ground Rules
Welcome to the GUH AMU teaching and learning site.
Formal teaching
Teaching is on every Tuesday at 0800-0900 in the CSI, room 2001. The session is attended by NCHDs, ANPs, consultants, and anyone else from the AMU team who would like to come. Please be on time.
The hour is split thus:
0800-0830: Classic cases: best clinical cases from last week.
Each person brings a case each week, of which three will be selected at random. The presentation is done at the whiteboard. Ten minutes are allowed for presentation and discussion of each case. Present a brief vignette (history and physical), then ask for a differential diagnosis from the audience, then detail the results of any investigations and the outcome of the clinical case. Mention what guidelines you used and give a link to evidence that people can read at their leisure. You'll be on a clock. No PowerPoint. None. Whatsoever.
0830-0850: What works when?
Ten minutes on treatments in specific conditions that actually have a mortality benefit (ARR and NNT), and ten on investigations that actually work (positive LR). This is done on a rotating basis. See the attached schedule.
The person responsible for resourcing the topic session will provide the relevant learning materials and post it on this website the Friday in advance. Everyone will have a chance to read it and then discuss further in-session. This is a 'flipped' learning model.
0850-0900: Quick QI
Updates on QI ongoing around the department.
Teaching on the floor
This happens on Tuesdays, Wednesdays and Thursdays after the midday huddle and involves a brief discussion of the most educationally interesting case on the floor. Again, a brief presentation followed by discussion of the differential diagnosis, further investigation and management. The session should last about 15 minutes and is led by the consultant of the day.
Feel free to include papers, literature reviews, guidelines, links to videos and podcasts, and whatever else you think might be useful.
The topics assigned are mapped to the MRCPI and UK AIM curricula. The latter is most useful for the AMU environment as it is predominantly symptom-based, as opposed to system based.
The schedule is not set in stone. If you want to swap sessions, or are on leave, let me know and we can move things around.
Formal teaching
Teaching is on every Tuesday at 0800-0900 in the CSI, room 2001. The session is attended by NCHDs, ANPs, consultants, and anyone else from the AMU team who would like to come. Please be on time.
The hour is split thus:
0800-0830: Classic cases: best clinical cases from last week.
Each person brings a case each week, of which three will be selected at random. The presentation is done at the whiteboard. Ten minutes are allowed for presentation and discussion of each case. Present a brief vignette (history and physical), then ask for a differential diagnosis from the audience, then detail the results of any investigations and the outcome of the clinical case. Mention what guidelines you used and give a link to evidence that people can read at their leisure. You'll be on a clock. No PowerPoint. None. Whatsoever.
0830-0850: What works when?
Ten minutes on treatments in specific conditions that actually have a mortality benefit (ARR and NNT), and ten on investigations that actually work (positive LR). This is done on a rotating basis. See the attached schedule.
The person responsible for resourcing the topic session will provide the relevant learning materials and post it on this website the Friday in advance. Everyone will have a chance to read it and then discuss further in-session. This is a 'flipped' learning model.
0850-0900: Quick QI
Updates on QI ongoing around the department.
Teaching on the floor
This happens on Tuesdays, Wednesdays and Thursdays after the midday huddle and involves a brief discussion of the most educationally interesting case on the floor. Again, a brief presentation followed by discussion of the differential diagnosis, further investigation and management. The session should last about 15 minutes and is led by the consultant of the day.
Feel free to include papers, literature reviews, guidelines, links to videos and podcasts, and whatever else you think might be useful.
The topics assigned are mapped to the MRCPI and UK AIM curricula. The latter is most useful for the AMU environment as it is predominantly symptom-based, as opposed to system based.
The schedule is not set in stone. If you want to swap sessions, or are on leave, let me know and we can move things around.
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