Session 1: Audit presentation / Case Presentation
RCEM audit - Vital signs in Children
Sets of vital signs consist of: temperature, respiratory rate, heart rate, blood oxygen saturation measured by pulse oximetry, level of consciousness expressed as Glasgow Coma Scale (GCS) or AVPU (alert, response to voice, responsive to pain or unresponsive) scale, and capillary refill time.
Vital signs are frequently recorded in children presenting at Emergency Departments because, if abnormal, they indicate that a patient has deranged physiology. This derangement is often indicative of a disease process and associated with an increased risk of morbidity and mortality. The detection of abnormal vital signs, appropriate escalation and response can avoid the patients' deterioration and improve patient outcomes.
LEARNING POINT: we should encourage vital sings to be documented on dedicated paediatric observation charts, which will help calculate the PEWS and spot the sick child.
Case Presentation: scrotal pain in a young boy
"I am always asking myself: “Why is it NOT testicular torsion?” If I can’t answer that satisfactorily, that boy is going to theatre." ... so refer to the surgeons from ED!
Differential diagnosis of acute testicular pain in a boy
Painful testicle in a young boy
Saving balls: the acute scrotum
Testicular Torsion: Pearls and Pitfalls - (emdocs)
Session 2: Decompensated liver disease
There is now a care bundle for patients who present with decompensated liver disease - please print this and follow treatment guidelines.
Diagnostic ascitic tap technique
Session 3: Major incident refresher
This topic is part of the FRCEM curriculum ( HAP 20)
- any incident that requires an extraordinary response from health services – ambulance services, primary care, community services and hospital Trusts
- Natural or manmade
- Simple or compound
- Compensated or uncompensated.
All hazards approach : every incident is different, but the solution are the same
Major incident response principles : CSCATTT
Links to further reading
Major incidents part 1
Major incidents part 2
Take home points from a HMIMMS course
The Derrifoam Blog
Welcome to the Derrifoam blog - interesting pictures, numbers, pitfalls and learning points from the last few weeks. Qualityish CPD made quick and easy.....