@4hrEmergencyDoc

UK Emergency Dept consultant & Med Ed fan. Jack of all trades, master of none. All cases/images anonymised, non contemporaneous & for education only #FOAMed #ED

 London
Joined October 2010
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1.5KMedia
Replying to @EMSwami
waits in the 16 hour range and average 20-50 people in a waiting room at any time, RNs generally order basic applicable panels for docs to review and pull back/order imaging. holds are tying up beds for days, you’re admitted or discharged by the time you see the provider.
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4 year old with recurrent admissions for viral wheeze presents with 3/7 fevers 41.3 and new non itchy lesions. Imms UTD inc Chickenpox. ?cause ?ED Mx #EDCases
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Such a good few days at @EuropSocEM 2022. These are tough tough times in EM (clearly worldwide listening to colleges old & new) but the joy of connecting as people, educators and learners was such a rush and motivation to keep going. Don’t give up EM Peeps - you’re amazing! – at Schönefeld, Deutschland
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A privilege to present our PEM Adventure session at @EuropSocEM 2022 with the ever brilliant @DrKanaris and @danihalltweets - amazing audience participation showing that you can learn whilst still having fun! #EUSEM2022 #medicaleducation #PEM – at Berlin, Germany
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Patients will never forget how you made them feel #Kindness
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68yr male fall on right side. Painful bruised shoulder with reduced ROM ?Cause #EDCases
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42yr male fell backwards from electric scooter onto shoulder. Pain and swelling over scapula still 10/10 despite opiates. How do you treat Scapula fractures like this? #EMCases
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#BeKind
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11 month old found playing with an old toy on the living room floor and ?ingested magnet approx 3 hours ago. Asymptomatic throughout. Metal detector negative. What imaging do you do and how often… CXR? CXR+AXR? Lat AXR? #magnet #PEMCases
Medicine - An art or a science?
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8yr old Sri Lankan girl presents with 5/7 SOB and lethargy. Hx of fall from bed 1/52 ago but no other PMH. Obs stable Afebrile. WC 45.2 CRP 380 ?Cause ?ED MX #PEMCases
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60 Yr male right hand dominant confused and punched the wall. Swollen painful back of hand but no rotation of little finger ? ED Mx #EDCases
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28yr old man collapsed on minimal exertion. Recent medication change for worsening low mood. Obs: HR 75 BP 109/80 O2 99% BM 7.2 but ECG shows QTc 530 ?Cause ?ED Mx #EDCases
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Keep seeing a worsening of this toxic ‘achievement’ culture in students and trainees - sometime just doing your job as well as you can is plenty. Let’s remind ourselves and those that we supervise of this. #Sometimes #CharlieMacksey #NHS
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Medical education surely now needs to change to embrace the fact clinician and patient can look things up. What would you change to stop us asking students and trainees to memorize facts? #MedEd #Einstein
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When do you (first) ask a patient’s pronouns in Paeds ED? #PEM
17%Triage
3%Consultation
79%Never
58 votes • Final results
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15yr old deaf female found confused in the street smelling of alcohol with fresh looking head injury. Confused, combative and unable to read written questions. HR 135 BP 100/80 RR 35 T39.9 Pupils 6mm bilateral. ?Cause ?ED Mx #EDCases
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Busy weeks in the NHS can make us feel rubbish but remember the little things can make a big difference. 3 minutes of any of of these 10 steps can make such a change #Wellbeing #NHS
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Loving this @BMJLearning infographic on hip pain in young adults. So easy to simply dismiss it as ‘MSK’ - take a moment to think a little deeper and look for these red flags for Ortho and non-orthopaedic differentials #PED
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28yr female with known Sarcoidosis attends with 1/52 fatigue and dizzy spells and brief LOC. HR 90 BP 155/90 O2 99%. ?Cause ?Mx #ECG #EDCases (thanks @LITFLblog for the ECG…)
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