The Podcasts of the Royal New Zealand College of Urgent Care

Should we be listening for bowel sounds? Despite evidence suggesting they are not useful, I still think it is an important part of an urgent care assessment. Check out the papers mentioned. Elhardello O, Macfie J. Bowel Sounds: Is it Time for Surgeons to Hang-up their Stethoscopes?. World J Surg Surgical Res. 2018; 1: 1066. Link to paper. Breum BM, Rud B, Kirkegaard T, Nordentoft T. Accuracy of abdominal auscultation for bowel obstruction. World J Gastroenterol. 2015 Sep 14;21(34):10018-24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566372/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

What impact do your acute referral letters have on the admitting team? You may have noticed the initial upload contained the wrong audio file of an old podcast. Sorry, this has been corrected. Check out the papers mentioned Chauveau P, Mazet-Guillaume B, Baron C, Roy PM, Tanguy M, Fanello S. Impact du contenu du courrier médical sur la qualité du triage initial des patients adultes admis aux urgences [Impact of the referral letter on triage decisions in adult patients admitted to the emergency department]. Sante Publique. 2013 Jul-Aug;25(4):441-51. French. https://pubmed.ncbi.nlm.nih.gov/24404726/ van den Berge K, Mamede S, van Gog T, Romijn JA, van Guldener C, van Saase JL, Rikers RM. Accepting diagnostic suggestions by residents: a potential cause of diagnostic error in medicine. Teach Learn Med. 2012;24(2):149-54. https://pubmed.ncbi.nlm.nih.gov/22490096/ Staal J, Speelman M, Brand R, Alsma J, Zwaan L. Does a suggested diagnosis in a general practitioners' referral question impact diagnostic reasoning: an experimental study. BMC Med Educ. 2022 Apr 8;22(1):256 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8991944/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

We must be aware of the possibility of Cozen's phenomenon in urgent care. Check out the Radiopedia page by Tim Luijkx https://radiopaedia.org/articles/cozen-fracture-1 Check out the Orthobullets page by Macknett MD et al https://www.orthobullets.com/pediatrics/4025/proximal-tibia-metaphyseal-fractures--pediatric Check out the obituary of Dr Lewis Cozen. www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Today we hear of a case of Chopart injury presenting through urgent care. Thanks to Dr Antonio Castro. Check out the paper mentioned Metcalfe TSN, Aamir J, Mason LW. Chopart dislocations: a review of diagnosis, treatment and outcomes. Arch Orthop Trauma Surg. 2024 Jan;144(1):131-147. doi: 10.1007/s00402-023-05040-4. Epub 2023 Sep 15. PMID: 37715068; PMCID: PMC10774188. www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

2 years ago we spoke with Dr Tamsin Lillie, a Fellow of the RNZCUC who runs a medical charity that helps fund African students through medical training. Last time we spoke she was calling in from Malawi, but a chance meeting in person prompted a quick catch-up about what has been going on over the last 2 years and her hopes for the charity moving forward. www.medictomedic.org.nz www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Some common, non-psychotropic medications can have psychiatric side effects. Check out the article mentioned Prescriber Update 45(1): 5-8 March 2024 https://www.medsafe.govt.nz/profs/PUArticles/March2024/Unexplained-mood-and-behavioural-changes.html www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Hoffmann's sign is a simple test that can help in diagnosing cervical myelopathy and upper motor neurone disease as part of a thorough history and examination. Check out the paper mentioned Nemani VM, Kim HJ, Piyaskulkaew C, Nguyen JT, Riew KD. Correlation of cord signal change with physical examination findings in patients with cervical myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):6-10. doi: 10.1097/BRS.0000000000000659. PMID: 25341986. https://pubmed.ncbi.nlm.nih.gov/25341986/ Check out the Stat Pearls page. Whitney E, Munakomi S. Hoffmann Sign. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545156/ 2 videos from Ortho Eval Pal with Paul Marquis on YouTube that show the sign. https://www.youtube.com/watch?v=blj6Y0rrmtw https://www.youtube.com/watch?v=GJ-Q2ibYAHs www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Wellens' Syndrome is an ECG finding indicative of critical LAD stenosis. Recognising this ECG change is vital. Check out the Life in the Fast Lane post by Dr Mike Cadogan and Dr Robert Buttner from September 2021 https://litfl.com/wellens-syndrome-ecg-library/ This is a BMJ case report that is worth reading. Ramires TG, Sant'Anna J, Pais J, Picarra BC. Wellens' syndrome: a pattern to remember. BMJ Case Rep. 2018 Apr 10;2018:bcr2018224582. doi: 10.1136/bcr-2018-224582. PMID: 29636339; PMCID: PMC5893974. https://casereports.bmj.com/content/2018/bcr-2018-224582 www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

We must counsel about the possibility of abnormal uterine bleeding starting, or worsening when commencing oral anticoagulation. Check out the Prescriber update - December 2023 edition - https://www.medsafe.govt.nz/profs/PUArticles/PDF/Prescriber-Update-44-No.4-December-2023.pdf Check out the paper mentioned de Jong CMM, Blondon M, Ay C, Buchmuller A, Beyer-Westendorf J, Biechele J, Bertoletti L, Colombo G, Donadini MP, Hendriks SV, Jara-Palomares L, Nopp S, Ruiz-Artacho P, Stephan P, Tromeur C, Vanassche T, Westerweel PE, Klok FA. Incidence and impact of anticoagulation-associated abnormal menstrual bleeding in women after venous thromboembolism. Blood. 2022 Oct 20;140(16):1764-1773. doi: 10.1182/blood.2022017101. PMID: 35925686. https://pubmed.ncbi.nlm.nih.gov/35925686/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

An interesting eponymous syndrome with a Kiwi connection. Check out the Stat Pearls Page Tafti D, Cecava ND. Poland Syndrome. [Updated 2023 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532259/ https://www.ncbi.nlm.nih.gov/books/NBK532259/ Read more about Patrick Clarkson, MBE, FRCS - https://en.wikipedia.org/wiki/Patrick_Clarkson Read more about Jeremy Beadle, MBE - https://en.wikipedia.org/wiki/Jeremy_Beadle www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

In cases of ongoing post-prandial epigastric pain and sitophobia despite endoscopy work up and treatment perhaps we should remember to recall Dunbar Syndrome to our differential list. Check out the paper mentioned Li J, Tan XY, Megahed A, Evangelista A. Dunbar syndrome: An unusual cause of chronic postprandial abdominal pain. Radiol Case Rep. 2020 Aug 2;15(10):1747-1749. doi: 10.1016/j.radcr.2020.07.016. PMID: 32774573; PMCID: PMC7397697. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7397697/ Check out the Radiopedia page Gaillard F, Moore C, Glick Y, et al. Celiac artery compression syndrome. Reference article, Radiopaedia.org (Accessed on 22 Feb 2024) https://doi.org/10.53347/rID-1143 www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Grover disease might present through your urgent care. While not a critical or life-threatening condition, recognising it so we can advise and support your patient is important. To help us consider differentials for various presenting complaints there is a useful website you can use. Check out the Cunneliffe (TP) General Dermatology Diagnostic Tool - https://www.pcds.org.uk/general-dermatology-table Check out the Dermnet page on Grover disease - authored by Prof Amanda Oakley and Dr Ian Coulson- https://dermnetnz.org/topics/transient-acantholytic-dermatosis www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

When considering calcaneal fractures we must remember the Böhler angle and the angle of Gissane. Check out the Orthobullets page written by Crag Forsthoefel MD. https://www.orthobullets.com/trauma/1051/calcaneus-fractures Check out the Radiopaedia articles Benoudina S, Worsley C, Knipe H, et al. Gissane angle. Reference article, Radiopaedia.org (Accessed on 08 Feb 2024) https://doi.org/10.53347/rID-40094 Amini B, Worsley C, Weerakkody Y, et al. Böhler angle. Reference article, Radiopaedia.org (Accessed on 08 Feb 2024) https://doi.org/10.53347/rID-1002 www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Do you know about the Corona Mortis? Today with chat to Dr Tim Brabants who has seen a case and feels we should be aware of its potential in urgent care. Tim is a UK-trained doctor who has worked in the UK and South Africa, predominantly in emergency medicine. Now based in New Zealand, he is a senior Registrar with the RNZCUC Check out these resources on the Corona Mortis. Radiopaedia - Hsu C, Ismail M, Furaiji H, et al. Corona mortis. Reference article, Radiopaedia.org (Accessed on 30 Jan 2024) https://doi.org/10.53347/rID-39319 https://radiopaedia.org/articles/39319 Garrido-Gómez J, Pena-Rodríguez C, Martín-Noguerol T, Hernández-Cortes P. Corona mortis artery avulsion due to a stable pubic ramus fracture. Orthopedics. 2012 Jan 16;35(1):e80-2. doi: 10.3928/01477447-20111122-25. PMID: 22229619. https://pubmed.ncbi.nlm.nih.gov/22229619/ Sealy EB, Schammel CM, Varma R, Devane AM. Corona mortis in the setting of pelvic trauma: Case series and review of the literature. Am J Interv Radiol 2023;7:9. https://americanjir.com/corona-mortis-in-the-setting-of-pelvic-trauma-case-series-and-review-of-the-literature/ Cardoso GI, Chinelatto LA, Hojaij F, Akamatsu FE, Jacomo AL. Corona Mortis: A Systematic Review of Literature. Clinics (Sao Paulo). 2021 Apr 16;76:e2182. doi: 10.6061/clinics/2021/e2182. PMID: 33886786; PMCID: PMC8024925. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8024925/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Could caffeine withdrawal result in an urgent care visit? Check out the paper mentioned Sajadi-Ernazarova KR, Anderson J, Dhakal A, et al. Caffeine Withdrawal. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430790/ https://www.ncbi.nlm.nih.gov/books/NBK430790/#article-18757.s2 www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

An eponymous sign that helps in the diagnosis of glandular fever. Check out the paper mentioned. Otsuki T, Ishizuka K, Hirose M, Ie K. Hoagland sign in infectious mononucleosis. BMJ Case Rep. 2022 Nov 16;15(11):e252839. https://pubmed.ncbi.nlm.nih.gov/36384885/ Check out the obituary of Colonel Robert. J. Hoagland MD - https://courierpostonline.newspapers.com/article/the-charlotte-observer-robert-j-hoagland/82137229/ Check out the Patient.info page on glandular fever, written by Dr Colin Tidy - https://patient.info/ears-nose-throat-mouth/sore-throat-2/glandular-fever-infectious-mononucleosis Check out the book review of Hoagland's book. Moser RH. Infectious Mononucleosis. Arch Intern Med. 1968;121(6):572. doi:10.1001/archinte.1968.03640060086018 www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

This week, the world's best snooker players are competing for the Paul Hunter Trophy at the Masters in London. Paul sadly died of neuroendocrine tumours in 2006 whilst in his snooker prime. Check out the paper mentioned Ahmed M. Gastrointestinal neuroendocrine tumors in 2020. World J Gastrointest Oncol. 2020 Aug 15;12(8):791-807. doi: 10.4251/wjgo.v12.i8.791. PMID: 32879660; PMCID: PMC7443843. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443843/ Check out this blog page detailing Paul Hunter's diagnosis. This is from the Ronny Allan blog, someone also diagnosed with neuroendocrine cancer. https://ronnyallan.net/2020/10/09/paul-hunter-snooker-champion-and-neuroendocrine-cancer-patient-died-9th-october-2006/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

What is your acute referral rate from UC to secondary care? Check out the paper mentioned. Blinkenberg J, Hetlevik Ø, Sandvik H, Baste V, Hunskaar S. The impact of variation in out-of-hours doctors' referral practices: a Norwegian registry-based observational study. Fam Pract. 2023 Dec 22;40(5-6):728-736. https://pubmed.ncbi.nlm.nih.gov/36801994/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

Jean Batten was a New Zealand pioneering aviatrix who died of empyema. Check out Jean Batten's history. From the NZ History website - https://nzhistory.govt.nz/people/jean-batten From Te Ara, the Encyclopedia of New Zealand - https://teara.govt.nz/en/biographies/4b13/batten-jean-gardner From Wikipedia - https://en.wikipedia.org/wiki/Jean_Batten# Check out the paper mentioned - Dyrhovden R, Nygaard RM, Patel R, Ulvestad E, Kommedal Ø. The bacterial aetiology of pleural empyema. A descriptive and comparative metagenomic study. Clin Microbiol Infect. 2019 Aug;25(8):981-986. https://pubmed.ncbi.nlm.nih.gov/30580031/ Check out the Stat Pearls page - Garvia V, Paul M. Empyema. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459237/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Full Grip by Score Squad This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor

You might encounter an Ice Cream Headache over Christmas. Check out the International Classification of Headaches - Third Edition) Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658. PMID: 23771276. https://pubmed.ncbi.nlm.nih.gov/23771276/ Check out the paper mentioned Özyürek H, Koray Bayrak I, Yayici Köken Ö. Ice Cream Headache: Cerebral Blood Flow Evaluation. Turk Arch Pediatr. 2021 Jul 1;56(4):405-406. doi: 10.5152/TurkArchPediatr.2021.20247. PMID: 35005742; PMCID: PMC8655974. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655974/ www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc Music licensed from www.premiumbeat.com Christmas Elves by - Francesco D'Andrea This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals. Please ensure you work within your scope of practice at all times. For personal medical advice always consult your usual doctor