Looking for the name of a book. Like an English House of God Has a messy FONA story in it, an insulin OD.

The more major trauma I get to see, the more I distrust blood pressure as a marker of hypovolaemia

If lactate production Is primarily a result of intracellular anaerobic respiration. Why do we treat a high lactate with fluid? Optimise cardiac output and tissue perfusion? But what if you've got a raised lecture with normal BP and HR?

Here’s the #ECG of a 30-year-old woman who presented to the ER with chest pain and palpitations What’s the diagnosis?

I don't know the answer. But I sense the opportunity to give ketamine.

I consider myself an optimistic person. But if the first 24mg of lorazepsm doesn't sedate the patient, 4mg more is unlikely to solve the problem.

The patients with the hardest IV access are often the sickest, those with chronic health conditions or those with significant hospital anxieties. Attempting cannulation if there Is a reasonable chance of success Is fine, but turning them into a pin cushion for "learning" is not.

If I diagnosed nitrous oxide toxicity in the hospital And the patient lived a long way from the hospital. Is it logistically possible for the patient to get alternate day hydroxocobalamin injection from their GP?

Absolute: This pay deal is 1% better than the last one Relative: This pay deal is 33% better than the last one. Who said critical appraisal isn't fun?

Monday moving house Tuesday late on call Wednesday inducting 90 resident doctors Thursday, looking after 4 kids under 5 Send coffee

Apparently, you can't have well done toast on an NHS ward "It's policy" So I'll just sit here and enjoy my warm bread.

The difference between the written pathway and the pathway the patient actually takes is a forever hate of mine. Why write it down if we're then going to make it up anyway?

How the NHS appears to work over the summer. "Hello, super specialist service!" "Oh yes, Janet's looked after Mr. Jones for 20 years, very complex he is." "But Janet's on holiday for 6 weeks, can it wait? "An emergency, u say? Well, you better contact the Dr, lovely F1"

Pottys not allowed in paediatric wards as infection risk. My child will instead just poo on the floor because that's better.

📆 Next month at #RCEMasc: An exploratory cross-sectional study of the role of the consultant nurse and consultant practitioner in UK EDs St George's ED Collaborative Research Group Vicky Mummery #StGeorgesUniversityHospital #Network #Learn #CPD ➡️ Don't miss it, register to here - tinyurl.com/RCEMEventasc24

Which of the following effectively rule out a PE: a) Absence of chest pain b) Wells' score of 0 c) Presence of a CAP on a chest radiograoh d) No evidence of DVT e) None of the above, which is why PEs are such a bloody nuisance

New group of juniors, gave them a talk on "What happens when you muck up" Because I think talking about the inevitable error or incorrect diagnosis is better than just saying "it'll happen one day"

Scott Alex Nevard This is the trouble.. everyone knows the probability of pe is v low.. but as soon as the possibility of VTE is raised there just doesnt seem to be any way to reliably exclude without imaging.

Gutted that our regional course on communication with the dying patient and their families has been cut due to budget constraints. Was really valuable for IMTs, practicing communication skills In a safe, observed environment.