​A 2 year old boy is brought into resus. He is sitting on the trolley as shown.

He is tachypnoeic, tachycardic and has a soft stridor. He is left undisturbed in his chosen position, high flow oxgen is administered and an attempt is made to keep everyone calm! Anaesthetic support is summoned urgently and a quick resus CXR is obtained.

I was inspired to write this post after attending the Hector Course at Birmingham’s Heartlands Hospital. The course is designed to improve the care of elderly patients with trauma. One of the key messages I came away with was the vital importance of ensuring patients with Parkinson’s disease get their medications on time and that we do not poison them with drugs that will make their condition worse. If not, we risk causing distressing and potentially devastating consequences for our patients. Complications of missed PD medications include: prolonged length of stay, falls, pressure ulcers, rapidly deteriorating swallow, aspiration pneumonia and neuroleptic malignant-like syndrome (NMLS) —which can be life threatening.