Giles

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Giles

Giles

@Neal94G

Acute Med SCF

เข้าร่วม Ekim 2018
626 กำลังติดตาม872 ผู้ติดตาม
Giles
Giles@Neal94G·
@HaQ_mAn I get ED are shat on a lot and that must be frustrating, but you’ve taken your personal grievance with a local AIM Consultant and an anon and are now publicly making comments like the people you’re bemoaning. We all have anecdotes to use in response. Rise above it.
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The Med Reg
The Med Reg@MedRegoncall1·
🔴 Physician Assistant students strike again from GP land. This time they killed a high-risk patient who recently had a caesarean section and fobbed her off with an “anxiety” diagnosis 💀☠️ ⭕️ The lady had two fatal cardiac arrests and passed away. ⭕️ This PA student was only supervised by her PA mate. ⭕️ No mention of any GP oversight. Basically, the blind leading the blind.
The Med Reg tweet mediaThe Med Reg tweet mediaThe Med Reg tweet mediaThe Med Reg tweet media
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Giles
Giles@Neal94G·
@Medical_Nemesis @MedRegoncall1 In UK it is often GP. My wife had no obstetrics follow up post CS. Community midwives, health visitors, and GP review of wound healing.
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Medical Nemesis
Medical Nemesis@Medical_Nemesis·
@Neal94G @MedRegoncall1 I don’t know to what extent a GP is equipped to follow up postpartum women after an abdominal surgery. In the US such a woman would be under the care of an obstetrician.
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Giles
Giles@Neal94G·
@ShivaniM_KC @DrJoFranklin I’m most troubled that she had 3 separate appointments in 8 days (May 14 - telephone, May 15 in person and May 22) and not once does it appear a GP was involved. In a 3 week post-partum patient with asthma and learning difficulties.
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Giles
Giles@Neal94G·
@ShivaniM_KC @DrJoFranklin The full article elaborates a bit more. Normal HR, temp and CTPA showing no clots. But she was asthmatic, had a cough, tight chest, wheeze and dyspnoea, and no mention is made of sats, peak flow, bloods or steroids, only “a course of antibiotics” and home BP monitoring.
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Shivani Misra
Shivani Misra@ShivaniM_KC·
"Chest tightness but no overt chest pain" that well known 100% specific differentiator of anxiety vs other causes I think day 1 of medical school you learn that 'chest tightness' can be absolutely anything. Colossal leadership failure and nobody will be held accountable.
The Med Reg@MedRegoncall1

🔴 Physician Assistant students strike again from GP land. This time they killed a high-risk patient who recently had a caesarean section and fobbed her off with an “anxiety” diagnosis 💀☠️ ⭕️ The lady had two fatal cardiac arrests and passed away. ⭕️ This PA student was only supervised by her PA mate. ⭕️ No mention of any GP oversight. Basically, the blind leading the blind.

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Giles
Giles@Neal94G·
@Medical_Nemesis @MedRegoncall1 Will be interesting to see the outcome of the inquest. What is troubling is that she had 3 appointments: May 14 (telephone), May 15 (trainee clinic) and May 22 and was not once seen by a GP. That is very poor.
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Giles
Giles@Neal94G·
@Medical_Nemesis @MedRegoncall1 … investigations that a GP does not have. So I can make diagnoses of exclusion like anxiety much more reliably and rapidly. ECG, bloods, blood gas, CXR, period of prolonged observation: we can do that all in a few hours.
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Giles
Giles@Neal94G·
@Medical_Nemesis @MedRegoncall1 I won’t argue the point that we weren’t there and don’t have all the details. But shortness of breath in the postpartum period is a red flag and as someone who works in acute medicine, I would never say no to reviewing them in SDEC. I have the privilege of rapid access to…
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Medical Nemesis
Medical Nemesis@Medical_Nemesis·
@Neal94G @MedRegoncall1 You can consider hundreds of diagnoses. Does the broad work up happen realistically in that setting? Unlikely. Everything is very clear in retrospect.
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Giles
Giles@Neal94G·
@Medical_Nemesis @MedRegoncall1 You may be right and we weren’t there, but they did say she was tachypnoeic. They don’t mention if heart rate was assessed (albeit may have further convinced them it was anxiety…). Post-partum, I suspect most GPs would at least consider a PE.
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Medical Nemesis
Medical Nemesis@Medical_Nemesis·
@MedRegoncall1 Fatal PE may present asymptomatically and become a post mortem diagnosis. Her presentation from the article was non-specific for anything in particular. It’s your classically benign cold like symptoms with rapid progression to death.
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