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A board by Kimberly Keighron


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11 items · Last updated Wednesday 21st September 2016

IV Fluids Guide

A quick guide to IV fluid prescription for adults.  
Aoibhin McGarrity
almost 8 years ago


Guide to doing a venepuncture by the clinical skills tutors at the University of Liverpool  
over 7 years ago
Foo20151013 2023 e7fpn8?1444774293

The Importance Of Clinical Skills

In the USA the issue of indiscriminate use of expensive, sophisticated, and time consuming test in lieu of, rather than in addition to, the clinical exam is being much discussed. The cause of this problem is of course multifactorial. One of the factors is the decline of the teaching of clinical skills to our medical students and trainees. Such problems seem to have taken hold in developing countries as well. Two personal anecdotes will illustrate this. In the early nineties I worked for two years as a faculty member in the department of ob & gyn at the Aga Khan University Medical School in Karachi, Pakistan. One day, I received a call from the resident in the emergency room about a woman who had come in because of some abdominal pain and vaginal bleeding. While the resident told me these two symptoms her next sentence was: “… and the pelvic ultrasound showed…” I stopped her right in her tracks before she could tell me the result of the ultrasound scan. I told her: “First tell me more about this patient. Does she look ill? Is she bleeding heavily? Is she in a lot of pain and where is the pain? What are her blood pressure and pulse rate? How long has she been having these symptoms? When was her last menstrual period? What are your findings when you examined her ? What is the result of the pregnancy test?”. The resident could not answer most of these basic clinical questions and findings. She had proceeded straight to a test which might or might not have been necessary or even indicated and she was not using her clinical skills or judgment. In another example, the resident, also in Karachi, called me to the emergency room about a patient with a ruptured ectopic pregnancy. He told me that the patient was pale, and obviously bleeding inside her abdomen and on the verge of going into shock. The resident had accurately made the diagnosis, based on the patient’s history, examination, and a few basic laboratory tests. But when I ran down to see the patient, he was wheeling the patient into the radiology department for an ultrasound. "Why an ultrasound?" I asked. “You already have made the correct diagnosis and she needs an urgent operation not another diagnostic procedure that will take up precious time before we can stop the internal bleeding.” Instead of having the needless ultrasound, the patient was wheeled into the operating room. What I am trying to emphasize is that advances in technology are great but they need to be used judiciously and young medical students and trainees need to be taught to use their clinical skills first and then apply new technologies, if needed, to help them to come to the right diagnosis and treatment. And of course we, practicing physicians need to set the example. Or am I old fashioned and not with it? Medico legal and other issues may come to play here and I am fully aware of these. However the basic issue of clinical exam is still important. Those wanting to read more similar stories can download a free e book from Smashwords. The title is: "CROSSCULTURAL DOCTORING. ON AND OFF THE BEATEN PATH." You can access the e book here.  
DR William LeMaire
about 6 years ago

EMCrit Intubation Checklist

A call/response intubation checklist for Emergency Medicine and Critical Care Airway Management
over 5 years ago

High flow systems for apnoeic oxygenation |

Apnoeic oxygenation during laryngoscopy via nasal prongs has really taken off in the last couple of years in emergency department RSI, and is associated with decreased desaturation rates in out-of-hospital RSI.
over 5 years ago
100 0016

Alternative intubation techniques vs Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials

Interesting open access article from Switzerland! Alternative intubation techniques vs Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials
about 5 years ago

Emergency Medicine Literature of Note: A Little Intubation Checklist Magic

Hello, You comment on their specific checklist, however I have not been able to actually find the checklist. Do you have a link to the checklist they use?
about 5 years ago

Intramuscular And Subcutaneous Injections - Clinical Skills

This video - produced by students at Oxford University Medical School in conjunction with the faculty - demonstrates the principles and techniques underlying...
about 5 years ago

New £500,000 clinical skills unit for training medical students is opened at West Suffolk Hospital

A plaque has been unveiled to officially open West Suffolk Hospital’s new £500,000 clinical skills unit.
about 5 years ago

Head injury: assessment and early management | Guidance and guidelines | NICE

This clinical guideline updates and replaces Head injury (NICE guideline CG56). It offers evidence-based advice on the care of children, young people and adults with head injury.
almost 5 years ago

Endotracheal Intubation

This video details the steps necessary to successfully perform endotracheal intubation via direct laryngoscopy.
over 4 years ago