Wardround 28x05

This week's two minute tutorials: theme COPD (I will talk about these on the podcast)

Steroids in COPD (link) Dr Tuck
Antibiotics in COPD Dr Kidder
LTOT Dr Johnstone
Non-invasive Ventilation Dr Szulakowski
Smoking cessation Dr Islam


Further reading
NICE guidance on COPD 2004 ,
European Respiratory Society COPD standards


Interesting topics this week

Weight loss with HIV
http://www.hivmedicine.com/textbook/wasting.htm

Klebsiella septicaemia
http://www.emedicine.com/med/topic1237.htm

Lymphocytosis
http://www.aafp.org/afp/20001101/2053.html

Gastric erosions
http://www.emedicine.com/med/topic3565.htm

Anticoagulation in AF
http://www.sign.ac.uk/pdf/sign36.pdf


This week’s reading for discussion was A Necessary Inhumanity? Ruth Richardson. Journal of Medical Ethics 2000;26;104-106, from which I have reproduced the abstract below.

“It is argued that the phrase “Necessary Inhumanity” more accurately describes the alienation required of doctors in some circumstances, than do modern sanitized coinages such as ‘clinical detachment’. ‘Detachment’ and ‘objectivity’ imply separation, not engagement: creating distance not only from patients, but from the self: the process may well be required, but where it becomes too extreme or prolonged, it can damage everybody, including patients, family members, doctors themselves, and wider society. An awareness of the history of health care in the context of our society might assist self reflection–might help keep initiates in touch with the culture they have been induced to leave and might help them remain humane despite the bruising process of training.”


The reading for next week is Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure? Charlie S. Wang; J. Mark FitzGerald; Michael Schulzer; Edwin Mak; Najib T. Ayas JAMA. 2005;294:1944-1956.

Next week’s two minute tutorials are themed on the U&E

Sodium PS
Potassium DK
Creatinine NJ
Bicarbonate TI
Chloride M

Don’t forget your two minute tutorials should be concise and precise.




podcast



If anyone out there would like to submit two minute tutorials for the podcast, just leave me a note in one of the comments.