#twitfrg Transcript
Healthcare social media transcript of the #twitfrg hashtag.
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| Profile | Tweet |
|---|---|
 | Omar Amin @SherlockOmz @twitfrg #twitfrg Omar, 5th year medical student from glasgow uni |
| Omar Amin @SherlockOmz #Twitfrg Start by introducing yourself, then ABCDE assessment |
| Omar Amin @SherlockOmz #Twitfrg A - Speak to the patient Is the airway patent? Any airway noises? B- Sats, RR, Auscultate Chest, ?Deviated trachea, consider O2 if low sats C- HR, Cap refill, BP, Insert cannula if not done so already - ?IV Fluids. D- AVPU? Glucose? Check Pupils? E- How does abdo feel? |
| Omar Amin @SherlockOmz #Twitfrg wasn't sure the condition patient was in, sorry. Is patient able to give a history? How long have they been vomiting for? Characteristics - Bilious? Blood? Volume? Abdo Pain? Stools? Has nurse taken obs recently? Would be good to look at obs chart |
| Omar Amin @SherlockOmz #twitfrg If patient not acutely unwell, might be worthwhile looking at patient's notes or speaking to nurse looking after the patient. |
| Omar Amin @SherlockOmz #twitfrg How long has he had the d&v for? Any particular trigger? Travel Hx? Would like to assess hydration status |
| Omar Amin @SherlockOmz #twitfrg Mucous Membranes? Pitting Oedema/Check Ankles (unlikely cause he's 25) Confusion? Urine Output? |
| Omar Amin @SherlockOmz #twitfrg Obs chart - signs of hypotension? tachycardia? high resp rate? |
| Omar Amin @SherlockOmz #twitfrg Current BM? Urine Dip? Has he been in hospital before acutely unwell because of his diabetes? |
| Omar Amin @SherlockOmz #twitfrg When did he last take his insulin? Is there any ketones in his urine? Might be useful to check a blood gas? |
| Omar Amin @SherlockOmz #twitfrg I would like to do a venous blood gas, it would be less traumatic for the patient than arterial and hypoxia doesn't seem to be an issue in this case, mainly checking for lactate and acidosis (would also give us some info about electrolytes) |
| Omar Amin @SherlockOmz #twitfrg Would be best to check their SpO2, to check for any signs of hypoxia |
| Omar Amin @SherlockOmz #twitfrg I think venous blood gas would be best option |
| Omar Amin @SherlockOmz #twitfrg Presence of metabolic acidosis + hypokalaemia Would like to get IV Access (if not done so already) + give fluids, 500ml bag of saline given in 30mins-1hr to start with potassium added to bag |
| Omar Amin @SherlockOmz #twitfrg Sorry ! Thought role was FY1, would like to speak to nurses and get an available doctor is patient is unwell. |
| Omar Amin @SherlockOmz #twitfrg S- Tell the FY1 you are worried about this 25 y/o patient, he is tachyopnoeic and has had severe diarrhoea + vomiting. B- Patient has Diabetes (unsure what type) A- Carried out VBG which showed metabolic acidosis + hypokalaemia R- Request assesment + ?IV fluids |
| Omar Amin @SherlockOmz #twitfrg Tell Fy1 you have attempted to put in a cannula but were unable to get them |
| Omar Amin @SherlockOmz #twitfrg Give antiemetic IV - ?Ondansetron, to help with N+V Consider an insulin infusion / insulin sliding scale to try slowly bring down glucose |
| Omar Amin @SherlockOmz #twitfrg Unsure re: guidelines/evidence for sliding scale IV insulin infusion, with-hold patient's insulin till he is able to eat and drink again. |
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