Wardround 30ix05

This week’s two minute tutorials were based around hospital acquired infection.

Dr Jones told us about Semmelweiss and his discovery of the importance of hygiene in preventing death in hospitals. You can find a brief biography in the wikipedia.

Other two minute talks were:
MRSA bacteraemia (8/8) Dr Mohan has posted an A4 sheet summarising his talk on MRSA bacteraemia. (How about putting an HTML version out there Naveen?) You will see that handwashing is the core preventative measure.
Pseudomonal pneumonia (Nawaz, 5/8)
Catheter related urinary tract infection (Dr Siddiqui 8/8)
Clostridium difficile (Bhasker 5/8)
Hospital acquired pneumonia (Dr Kidder 8/8)

We were able to discuss the concept of ‘judicious’ antibiotic use. I hope my summary here does this some justice:
1. Be sure an antibiotic is needed
2. Take the necessary samples
3. Use local antibiotic guidelines
4. Give the correct dose, guided by levels when necessary
5. Use narrow spectrum when you can; if broad spectrum cover is required, narrow it as soon as culture results allow.

The term ‘aggressive’ antibiotic was voiced in discussion….synonymous, I presume, with very broad spectrum combinations. Can I suggest an alternative adjective for antibiotic use …let’s be meticulous rather than aggressive?

The reading for next week is: The practice of clinical medicine as an art and as a science
John Saunders. J Med Ethics: Medical Humanities 2000;26:18–22
You should be able to get the PDF using your Athens password.

Interesting topics this week:

Wolff-Parkinson-White
Split second heart sound (I’ll put more about this on the podcast)
Horner’s syndrome
Cerebellopontine angle tumours

Don’t forget your two minute tutorials…next week is acute coronary syndrome…make it concise and precise.

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

Semmelweiss, split second heart sounds, next week's reading...and some music.


MP3 File