A typical day in the NHS (and how much it costs) The NHS is big, really big. “Space [or the NHS!] is big. Really big. You just won’t believe how vastly hugely mind-bogglingly big it is. I mean, you may think it’s a long way down the road to the chemist, but that’s just peanuts […]
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7 ways to reduce risk of falls How common are falls and why do falls matter? Falls are a common, but often overlooked, cause of injury. Around 1 in 3 adults over 65 years, and 50% of people over 80 years will have at least one fall a year. In terms of why they matter, […]
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Taking my child to A+E with a mental health crisis – what to expect Attending A+E can be a distressing experience, especially if you are a young person suffering from a mental health crisis. A mental health crisis can include suicidal thoughts, self-harm, severe anxiety, delusional beliefs or a difficulty coping with your mental health at home. Here is a typical timeline of […]
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What do ‘sick day rules’ mean? If frail elderly patients (including those with CKD) become sick and dehydrated (usually secondary to an infection, e.g. urine, chest or gastrointestinal), they should be advised to withhold the 7 groups of medications below. This is because these drugs can precipitate AKI during such illnesses. And if they can be […]
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Which drugs cause falls in the elderly? Many can, but some do more than others. Therefore, prescribing the tablets below in the frail elderly, needs to be done with some thought and caution. “A fall in the frail elderly can have much worse consequences (e.g. #NOF) than the disease the drug is trying to prevent.” […]
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How to prescribe in the elderly With caution. Think about the risk : benefit analysis before your prescribe. For example, an 89y old does need to be started on a statin. There are 5 principles. 5 key points Treat the disease process rather than symptoms – just because someone has mild oedema, it may not […]
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What happens just before an operation? There are five main stages: 1. Arrival. For most operations you will come in to hospital on the day of surgery. You will be directed to an admission area or day surgery. You will meet your nurse who will introduce themselves and check you in. They will ask you to change […]
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What is a ‘pre-op’? The main purpose of a pre-operative assessment (or ‘pre-op’) is to identify diseases other than the disease about to treated (with an operation) that may lead to complications during the: Pre-anaesthetic (before op), Surgical (the op), Post-operative (after the op) period. It is usually an appointment with a nurse, either in person or virtual (video or […]
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Will I see an anaesthetist before my operation? No, not normally. If you are low risk and the operation is low risk. But if this is not the case, and you’re about to have an operation, you will normally need to see one – ideally the one who will do the operation. This is especially […]
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What is NHS Continuing Healthcare (CHC)? HS Continuing Healthcare (CHC) is free social care available to everyone. It is a quite well kept secret. It can fully-fund the care costs of a range of frail patients including those with dementia or long-term complex health needs. It is just for adults. CHC can be provided in a variety of settings outside […]
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