• This week I learnt- 5

    Controlling fever doesn’t seem to have any effect on serious outcomes or death. Controlling fever could be harmful but of course can be provided for comfort. It is probably safe to skip thrombolysis and go straight to thrombectomy. Beware winter’s morphology as STEMI mimic In kids with buckle fracture unlikely matters much what type of immobilisation is offered. That saying…

  • TWIL-4

    That the biggest decrease in a patient’s angina symptoms come form telling them the lesion they have isn’t going to cause a problem. Explored more; apparently about a third had symptoms completely improved. Clinical prediction tools are much better validated to “rule out” than “rule in” the need for intervention. The “weekend effect” is more likely due to lack of…

  • TWIL-3

    This week I learnt The SNOOP mnemonic is useful to rule out serious cause of acute headache Pain scores at triage are not associated with admission or mortality In rotator cuff shoulder pain a one of session of physio is equally effective than a long course (but no placebo control). Ebola has made (another) resurgence in the democratic republic of…

  • TWIL-2

    This week I learnt A 6 hour CT is the key to ruling out Subarachnoid haemorrhage (if reported by a neuro-radiologist) It might be time to reframe “sepsis” as a part of the dying process in a significant proportion of patients. Statically broad-complex tachycardia is going to be VT. Cerebral oedema in DKA doesn’t seem to related to sodium.  

  • TWIL 1

    This week I learnt . . . Antibiotics are no longer indicated for simple diverticulitis (NICE guidelienes from 2019), This is based on a bang up to date RCT from 2012. In major trauma, a high glucose(>11) is associated with mortality. (But not as much as age and hyperthermia). Emergency doctors and patients disagree about the presenting complaint about a…