Patient safety takes centre stage at this year’s St Andrew’s Day Symposium, with a keynote lecture exploring innovations and lessons that influence safer care across acute settings.  Be part of the discussion shaping the future of practice.  Book now: rcpe.ac.uk/events/st-andr…

Such a fascinating introduction to ambient listening technology and AI clinical notes by Heidi Health at #rcpeStAs25 - designed and led by doctors for doctors. Reckon I could see twice as many patients on the acute take with such tech support!

A reminder of red flag indicators for investigating headaches at the front door - if these criteria are not met than migraine is massively most likely, though amber flags like recent head trauma, precious cancer or HIV etc should be considered - Mireia Moragas-Garrido #rcpeStAs25

Extremely helpful algorithm by Mireia Moragas-Garrido for management of migraines at the front door. Parenteral metoclopramide/prochlorperazine both have direct analgesia (as well as antiemetic) effects in migraine! Opioids are NOT effective & should not be used! #rcpeStAs25

Reminder about mainstays of hyperkalaemia management in AKI by Lynne Sykes #rcpeStAs25. Potassium binders like Lokelma one of the recent exciting advances that has changed front door AIM!

Our new Royal College of Physicians of Edinburgh Vice President for Scotland and Northern Ireland, Dr Marion Slater, opens day two of #rcpeStAs25. Welcome to all our speakers and delegates!

Anaphylaxis top tips from Andrew Whyte at #rcpeStAs25 Key take home points: - do NOT delay IM adrenaline - no role for steroids (may actually cause more harm than good, as early use associated with increased ITU requirement)

Left atrial ablation for AF gives better symptom control than drugs for patients w AF BUT less benefit with persistent AF. Do not refer: - if no symptoms - if frail / sig comorbid - BMI >40 (weight loss first) Thanks to Douglas Elder #rcpeStAs25

BSG/BASL cirrhosis care bundle highlights from Alastair MacGilchrist #rcpeStAs25: - ascitic tap vital - USS to seek cancer/PV thrombosis as cause of deterioration - better outcomes if low Mg replaced - high risk VTE (double risk) so prophylaxis unless plts <50

Stigma around alcohol use disorder highlighted by Alastair MacGilchrist at #rcpeStAs2025. Avoid nihilism - 50% of patients admitted with decompensated ALD successfully STOP drinking!

Thyroid clinical pearls from Marie Freel at #rcpeStAs25 Amiodarone-induced thyrotoxicosis may have vaguer presentation as classic symptoms may be masked by... amiodarone! 200mg amiodarone = 20 x typical dietary intake of iodine!

Helpful reminder about distinguishing epileptic vs functional seizures by Kathryn Knight at #rcpeStAs25 Urinary incontinence, elevated lactate and hypoxia can occur in either & do NOT help with differentiating between the two!

Tips from Kathryn Knight at #rcpeStAs25 for safety advice when sending patients home from the AMU following a fit, including: - must not drive! - showers, not baths - avoid locking doors - cooking: use the back hobs! - no lone swimming - avoid provoking factors