The Medical Take

Dr Pauline Grose (Lead Consultant for Medical HDU at Glasgow Royal Infirmary) joins us to talk about the exciting and intimidating topic of HDU. What makes a unit an HDU? How can we best decide which patients will benefit from transfer to HDU? And what are the challenges? The Faculty of Intensive Care Medicine website https://www.ficm.ac.uk/ Intensive Care Society website https://ics.ac.uk/ Scottish Intensive Care Society Audit Group https://www.sicsag.scot.nhs.uk/index.html The Society for Acute Medicine https://www.acutemedicine.org.uk/

Dr David Gray (Consultant in Palliative Care) chats to us about his approach to palliative care, and gives tips and tricks on best management for patients who might be nearing the end of life. Scottish Palliative Care Guidelines https://www.palliativecareguidelines.scot.nhs.uk/ Guidance At End Of Life (GAEL) for Health Care Professionals https://clinicalguidelines.nhsggc.org.uk/palliative-care/guidance-at-end-of-life-gael-for-health-care-professionals-543/ Macmillan Cancer Support – Difficult conversations (including REDMAP) https://www.macmillan.org.uk/coronavirus/healthcare-professionals/difficult-conversations Edited by Ryan Norrie

Join the College Arrianne and Daniel discuss pulmonary embolism. Edited by Ryan Norrie

Join the College Daniel and Arrianne are joined by Kirsty Crowe to talk about care of the renal transplant patient. Edited by Ryan Norrie

Join the College Dr Robert Docking (Consultant in Intensive Care Medicine and Anaesthesia) in conversation with Arrianne about difficult conversations: what are they and how can we make them less difficult for all involved. NHS GG&C Guidance At End Of Life (GAEL) for Health Care Professionals https://www.palliativecareggc.org.uk/?page_id=66 Macmillan Difficult conversations https://www.macmillan.org.uk/coronavirus/healthcare-professionals/difficult-conversations Cruse Scotland https://www.crusescotland.org.uk/ Difficult Conversations: We need to talk about dying https://www.hazelwhitedesign.co.uk/videos/v/difficult-conversations-why-we-need-to-talk-about-dying With the End in Mind: How to Live and Die Well - Kathryn Mannix Listen: How to Find the Words for Tender Conversations - Kathryn Mannix The Way We Die Now - Seamus O'Mahony Edited by Ryan Norrie

Join the College Nicola Cooper Consultant Physician & Clinical Associate Professor in Medical Education at Nottingham University joins the team to talk about how we make decisions and how we can make better ones. ABC of Clinical Reasoning (2nd edition), edited Nicola Cooper and John Frain. Edited by Ryan Norrie

Join the College Beth Routledge (Consultant in Acute Medicine) brings us a case to discuss of a pregnant patient with chest pain and teaches us what is the same in the investigation and management of the pregnant and non-pregnant patient, and where we need to think differently. Show notes: https://www.rcplondon.ac.uk/guidelines-policy/acute-care-toolkit-15-managing-acute-medical-problems-pregnancy https://thorax.bmj.com/content/58/6/470 https://www.medicinesinpregnancy.org/ https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/reducing-the-risk-of-thrombosis-and-embolism-during-pregnancy-and-the-puerperium-green-top-guideline-no-37a/ https://www.npeu.ox.ac.uk/mbrrace-uk/reports https://pubmed.ncbi.nlm.nih.gov/29782079/ https://archive-ouverte.unige.ch/unige:167111 https://academic.oup.com/eurheartj/article/39/34/3165/5078465?login=true#186438440

Join the College Daniel speaks to David Hunter, Specialty Registrar in Cardiology, about the approach to tachy- and bradyarrhythmias covering their initial treatment in the hospital environment and when to phone your local friendly cardiologist. Edited by Ryan Norrie

Join the College Our guest for this episode on frailty in older people is Dr Jenni Burton, NES/CSO Clinical Lecturer & Honorary Specialist Registrar at the University of Glasgow and ST6 in Geriatric & General Internal Medicine, discussing what frailty is, what effects it can have, and what we can do about it. BGS Silver Book 2: https://www.bgs.org.uk/resources/resource-series/silver-book-ii RCP & SAM Acute Care Toolkit: https://www.rcplondon.ac.uk/file/26896/download 4AT: https://www.the4at.com SIGN Delirium for patients & carers: https://www.sign.ac.uk/assets/pat157.pdf Edited by Ryan Norrie

Join the College Hello and welcome to episode 1 of the second series of The Medical Take, a podcast from Royal College of Physicians & Surgeons of Glasgow. I’m Arrianne Laws and I’m Daniel Lynagh and this time we’re talking about the assessment of a patient who has presented with a LOC. Case history - patient in their 20s found collapsed, awake but confused on a Friday night in town. Was out with friends but got separated, What are the things that are immediately going through your head? https://cks.nice.org.uk/topics/epilepsy/diagnosis/differential-diagnosis/ https://cks.nice.org.uk/topics/epilepsy/diagnosis/assessment Edited by Ryan Norrie

Join the College Dr Celia Jackson joins Laura discussing cases around the diagnosis and management of HIV Edited by Ryan Norrie

The Medical Take returns, 9th February! Join the College

Join the College In the final episode of series 1, Dr Beth Routledge and Dr Arrianne Laws discuss headaches in pregnancy. People get headaches all the time, and pregnant patients are no exception. When should we be taking these more seriously and doing more tests, and what treatments can we use for a pregnant patient? We speak to Dr Beth Routledge to find out. Find out more: https://rcpsg.ac.uk/college/this-is-what-we-do/the-medical-take Edited by Ryan Norrie

Join the College We see multiple patients every day who present with shortness of breath, but what's the best way to work them up? How can we tell those with a dangerous problem that needs something done about it now from those with less acute issues? Daniel Lynagh and Laura Gillespie discuss how best to approach the clinical assessment of a breathless patient. Edited by Ryan Norrie

Join the College We're joined by Stephen Vargas from Terence Higgins Trust to talk through issues around gender, sexual health and what we can do to be better clinicians looking after LGBT people. Find out more: https://rcpsg.ac.uk/college/this-is-what-we-do/the-medical-take Edited by Ryan Norrie

Join the College Sugars run high in this week’s episode as we discuss diagnosis, investigation and management of patients with diabetic emergencies. We’re joined by Joe Timmons, Specialist Trainee in Diabetics & Endocrinology to guide us through ketoacidosis, hyperosmolar states and more! Edited by Ryan Norrie

Join the College Dr Arrianne Laws and Dr Laura Gillespie discuss different presentations of anogenital ulceration. We talk about how to ask those more 'sensitive' questions; what investigations to order; and initial management. Edited by Ryan Norrie

Join the College We’re joined by Dr Jennie Cathcart to talk about the presentation, investigation and management of gastrointestinal bleeding. What does the generalist need to know? Edited by Ryan Norrie

Join the College A patient presents with raised inflammatory markers and a headache: what should you do? Is this just an older patient with a viral illness and sinusitis or are they in danger of losing their sight and need steroids ASAP? We discuss a case. Find out more: https://rcpsg.ac.uk/college/this-is-what-we-do/the-medical-take Edited by Ryan Norrie

Join the College The creatinine is rising, but you don’t know why. We can help! From initial management to trying to figure out who needs something more sophisticated than a urinalysis checked, we guide you through this everyday clinical problem with our guest Benjamin Elyan. Find out more: https://rcpsg.ac.uk/college/this-is-what-we-do/the-medical-take Edited by Ryan Norrie