The Unofficial Guide to Medical and Surgical Emergencies

1st Edition - December 24, 2022
Editors: Zeshan Qureshi, Varshini Manoharan, Vijaytha Muralidharan, Agalya Ramanathan, Jameela Sheikh, Anna Kathryn Taylor
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 9 3 6 7 4 - 3
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 3 6 7 1 - 2
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 9 3 6 7 2 - 9

The unique and award-winning Unofficial Guides series is a collaboration between senior students, junior doctors and specialty experts. This combination of contributors understan… Read more

The Unofficial Guide to Medical and Surgical Emergencies

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The unique and award-winning Unofficial Guides series is a collaboration between senior students, junior doctors and specialty experts. This combination of contributors understands what is essential to excel on your course, in exams and in practice – as well as the importance of presenting information in a clear, fun and engaging way. Packed with hints and tips from those in the know, when you are in a hurry and need a study companion you can trust, reach for an Unofficial Guide.

The Unofficial Guide Medical and Surgical Emergencies offers a collection of common clinical emergency scenarios. It walks you through the practical steps of the decision-making process, from taking a referral through to making a management plan and prescribing – all designed to ensure safe and best practice.

With plenty of tips to support your clinical reasoning, real time examples, and a focus on initial management before a diagnosis is clear, this book is ideal for medical students as well as junior doctors wanting a quick reference guide or revision aid.

Cover image
Title page
Table of Contents
Copyright
Dedication
Series Editor Foreword
Foreword
Introduction
About the Editors
Contributors
Reviewers
1. Starting the Job
Station 1.1: Prioritisation
Types of Tasks and How to Prioritise
Other Aspects of Prioritisation
Station 1.2: Handover and Escalation
What is Handover?
How do you Hand Over a Patient?
Examples and Explanation
Escalation
Multidisciplinary Team (MDT) Members
Station 1.3: An Introduction to Clinical Decision Making
Station 1.4: Clerking
What is Expected of You?
Suggested Headings
Ward Round
Summary
Station 1.5: Discussing ‘Do Not Attempt CPR’ Orders
Raising the Topic
Documentation
Station 1.6: Updating Relatives
Initial Thoughts
Conversation
Closing
Station 1.7: Application of Key Ethical Principles
Initial Thoughts
Assessment
Four Pillars of Medical Ethics
Management
Station 1.8: Discharge Summaries
Initial Thoughts
Assessment
TTOS
Writing a Discharge Summary
An Example Structure
2. Data Interpretation
Station 2.1: Arterial Blood Gas Interpretation
Initial Thoughts
Components
Interpretation
Station 2.2: ECG Interpretation
Initial Thoughts
Interpretation
Station 2.3: Blood Test Interpretation
Initial Thoughts
Full Blood Count
Urea and Electrolytes
Liver Function Tests
3. Prescribing
Station 3.1: Intravenous Fluids
What is Expected of You?
Common Scenarios
Summary
Escalation
Station 3.2: Analgesia
What is Expected of You?
The Who Pain Ladder
Special Scenarios: Palliative Care
Summary
Station 3.3: Antiemetics
What is Expected of You?
Mechanism of Vomiting (Figs 3.4 and 3.5)
Differential Diagnosis
Use in Chemotherapy
Summary
Station 3.4: Blood Transfusion
What is Expected of You?
Prescribing and Administering Blood Products
Special Scenarios
Summary
Station 3.5: Gentamicin
What is Expected of You?
Dose Calculations
Summary
Station 3.6: Vancomycin
What is Expected of You?
Dose Calculations – IV Use
Dose Calculations – Oral Use
Summary
Station 3.7: Insulin
What is Expected of You?
Common Scenarios
Escalation
Summary
Station 3.8: VTE Prophylaxis
What is Expected of You?
Risk Assessment
Important Contraindications to Pharmacological Prophylaxis
Communication with Patients and Family/Carers
Commonly Prescribed Pharmacological VTE Prophylaxis (Table 3.21)
Special Scenarios
Summary
Station 3.9: Warfarin
What is Expected of You?
Common Scenarios
Escalation
Summary
4. Radiology
Station 4.1: The Chest X-Ray
Initial Thoughts
Indications for a CHEST X-RAY
Requesting Radiological Imaging
Discussing Radiological Imaging with a Radiologist
Interpreting The Chest X-RAY
Station 4.2: The Abdominal X-Ray
Initial Thoughts
Indications for the Abdominal X-RAY
Interpreting the Abdominal X-RAY
Station 4.3: The CT Head
Initial Thoughts
Indications for a CT Head
Interpreting the CT Head
5. Recognition and Assessment of the Acutely Unwell Patient
Station 5.1: Assessment And Resuscitation
A – Airway
B – Breathing
C – Circulation
D – Disability
E – Exposure
Station 5.2: Cardiac Arrest
Initial Thoughts
Assessment and Resuscitation
Escalation
Station 5.3: Respiratory Failure
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 5.4: Haemorrhage
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 5.5: Burns
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 5.6: Anaphylaxis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 5.7: Sepsis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
6. Cardiology
Station 6.1: Acute Coronary Syndrome
Station 6.2: Bradycardia
Station 6.3: Narrow-Complex Tachycardia
Station 6.4: Broad-Complex Tachycardia
Station 6.5: hypertensive emergencies
Station 6.6: Acute Exacerbation of Congestive Heart Failure
Station 6.7: Endocarditis
7. Respiratory
Station 7.1: Acute Exacerbation of Asthma
Station 7.2: Acute Exacerbation of Copd
Station 7.3: Community-Acquired Pneumonia
Station 7.4: Pleural Effusion
Station 7.5: Pneumothorax
Station 7.6: Pulmonary Embolism
8. Gastroenterology
Station 8.1: Abdominal Sepsis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 8.2: Acute Diarrhoea and Vomiting
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 8.3: Acute Liver Failure
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 8.4: Acute Upper Gastrointestinal Bleed
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 8.5: Exacerbation of Inflammatory Bowel Disease
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 8.6: Spontaneous Bacterial Peritonitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
9. Endocrinology
Station 9.1: Diabetic Ketoacidosis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.2: Hyperosmolar Hyperglycaemic State
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.3: Hypoglycaemia
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.4: Hypocalcaemia
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.5: Hypercalcaemia
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.6: Hyperkalaemia
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.7: Hypokalaemia
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.8: Hyponatraemia
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 9.9: Adrenal (Addisonian) Crisis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
10. Neurology
Station 10.1: Stroke and Transient Ischaemic Attack
Initial Thoughts
Differential Diagnosis
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 10.2: Seizures
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Making a Diagnosis
Management
Escalation
Station 10.3: Subarachnoid Haemorrhage
Initial Thoughts
Making a Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 10.4: Meningitis
Initial Thoughts
Making a Diagnosis
Initial Diagnosis
Initial Instructions Over The Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 10.5: Reduced GCS
Initial Thoughts
Making a Diagnosis
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 10.6: Spinal Cord Compression
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Making a Diagnosis
Differential Diagnosis
Initial Investigations
Management
Escalation
11. Elderly Care Medicine
Station 11.1: Comprehensive Geriatric Assessment
Initial Thoughts
What is the Comprehensive Geriatric Assessment?
The Four Key Components of the Cga
Summary
Station 11.2: Frailty
Initial Thoughts
Frailty and its Relevance to Clinical Practice
Rockwood’S Clinical Frailty Scale (CFS)
Subsequent Actions
Summary
Station 11.3: Falls Review
Initial Thoughts
Assessment and Resuscitation
Making a Diagnosis
Initial Investigations
Management
Escalation
12. Haematology and Oncology
Station 12.1: Anaemia
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 12.2: Neutropenic Sepsis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 12.3: Reversal Of INR
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 12.4: Superior Vena Cava Obstruction
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 12.5: Tumour Lysis Syndrome
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
13. Toxicology
Station 13.1: Tricyclic Antidepressant Toxicity
Initial Thoughts
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 13.2: Benzodiazepine Toxicity
Initial Thoughts
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 13.3: Opiate Toxicity
Initial Thoughts
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 13.4: Organophosphate Toxicity
Initial Thoughts
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 13.5: Paracetamol Toxicity
Initial Thoughts
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 13.6: Salicylate Toxicity
Initial Thoughts
Assessment and Resuscitation
Initial Investigations
Management
Escalation
14. Dermatology
Station 14.1: Cutaneous Drug Reactions
Station 14.2: Erythroderma
Station 14.3: Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
15. Psychiatry
Station 15.1: Acute Alcohol Withdrawal
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 15.2: Acute Psychosis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 15.3: Capacity Assessment
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment And Resuscitation
Initial Investigations
Management
Escalation
Station 15.4: Delirium
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 15.5: Suicide Risk Assessment
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Management
Escalation
16. Palliative Care
Station 16.1: Breaking Bad News
Station 16.2: Death: The Legalities
Station 16.3: Palliative Care
17. General Surgery
Station 17.1: Acute Appendicitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.2: Acute Cholecystitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.3: Acute Cholangitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.4: Acute Pancreatitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.5: Bowel Obstruction
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.6: Acute Diverticulitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.7: Lower Gastrointestinal Bleeding
Initial Thoughts
Differential Diagnosis
Initial Instruction Over Phone
Assessment and Resuscitation
Initial Investigations
Management
Escalation
Station 17.8: Hernias
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 17.9: High Iliostomy Output
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigation
Making A Diagnosis
Management
Escalation
18. Renal and Urology
Station 18.1: Urinary Retention
Initial Thoughts
Differential Diagnosis
Initial Instructions
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 18.2: Pyelonephritis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 18.3: Acute Kidney Injury
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 18.4: Haematuria
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 18.5: Renal Colic
Initial Thoughts
Differential Diagnosis
Initial Instructions Over The Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
19. Vascular
Station 19.1: Aortic Dissection
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 19.2: Abdominal Aortic Aneurysm
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 19.3: Acute Limb Ischaemia
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 19.4: Deep-Vein Thrombosis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
20. Orthopaedics
Station 20.1: Acute Osteomyelitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 20.2: Colles’ Fracture
Initial Thoughts
Differential Diagnoses
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 20.3: Acute Compartment Syndrome
Initial Thoughts
Differential Diagnoses
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 20.4: Neck of Femur Fracture
Initial Thoughts
Differential Diagnoses
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Garden Classification for Intracapsular Fractures (Fig. 20.6)
Management
Escalation
Station 20.5: Open Fractures
Initial Thoughts
Differential Diagnoses
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
Station 20.6: Septic Joint
Initial Thoughts
Differential Diagnoses
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making A Diagnosis
Management
Escalation
21. Ear, Nose and Throat
Station 21.1: Dysphagia
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 21.2: Epistaxis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 21.3: Foreign Body in the Nose
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 21.4: Post-tonsillectomy Bleed
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment And Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 21.5: Quinsy
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 21.6: Stridor
Initial Thoughts
Differential Diagnosis
Initial Instructions Over Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 21.7: Tracheostomy Assessment
Initial Thoughts
Initial Instructions Over Phone
Assessment and Resuscitation
Making a Diagnosis
Management
Escalation
22. Ophthalmology
Station 22.1: Acute Angle Closure Glaucoma
Initial Thoughts
Differential Diagnosis
Initial Instructions Over the Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 22.2: Amaurosis Fugax
Initial Thoughts
Differential Diagnosis
Initial Instructions Over the Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Station 22.3: Orbital Cellulitis
Initial Thoughts
Differential Diagnosis
Initial Instructions Over the Phone
Assessment and Resuscitation
Initial Investigations
Making a Diagnosis
Management
Escalation
Index

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The Unofficial Guide to Medical and Surgical Emergencies

Purchase options

Institutional subscription on ScienceDirect

Zeshan Qureshi

Varshini Manoharan

Vijaytha Muralidharan

Agalya Ramanathan

Jameela Sheikh

Anna Kathryn Taylor