28 min

The intern suppository Ward Calls

    • Medicine

Dr Ivor Popovich presents examples of evidence-based decision making during ward calls. We also highlight some recommendations from Choosing Wisely and give an update on death certification.



* The Intern Suppository – Ivor’s EBM blog

* The Rational Clinical Examination – JAMA

* Plain film in small bowel obstruction



* The gas-less abdomen

* Paucity of gas

* Non-specific bowel gas pattern

* Read more in the blog post here





* Plasmalyte in renal failure



* Not contra-indicated

* Actually alkalinises plasma, driving potassium into cells

* The chloride in NaCl acidifies plasma, drawing potassium into the extracellular space

* Read more in the blog post here





* Asthma admission



* Tachycardia is not explained by salbutamol administration alone

* A large diurnal variation in peak flow (e.g. >50%) is a major risk factor for in-hospital cardiac arrest (not severity of asthma exacerbation at admission).

* Severity of wheeze does not correlate with severity of exacerbation

* Read more in the blog post here





* Choosing wisely

* New Death Documents website

* MOH Completing the Medical Certificate Cause of Death form (March 2018)

* MOH Examples of incorrect and correct cause of death certification (March 2018)

Dr Ivor Popovich presents examples of evidence-based decision making during ward calls. We also highlight some recommendations from Choosing Wisely and give an update on death certification.



* The Intern Suppository – Ivor’s EBM blog

* The Rational Clinical Examination – JAMA

* Plain film in small bowel obstruction



* The gas-less abdomen

* Paucity of gas

* Non-specific bowel gas pattern

* Read more in the blog post here





* Plasmalyte in renal failure



* Not contra-indicated

* Actually alkalinises plasma, driving potassium into cells

* The chloride in NaCl acidifies plasma, drawing potassium into the extracellular space

* Read more in the blog post here





* Asthma admission



* Tachycardia is not explained by salbutamol administration alone

* A large diurnal variation in peak flow (e.g. >50%) is a major risk factor for in-hospital cardiac arrest (not severity of asthma exacerbation at admission).

* Severity of wheeze does not correlate with severity of exacerbation

* Read more in the blog post here





* Choosing wisely

* New Death Documents website

* MOH Completing the Medical Certificate Cause of Death form (March 2018)

* MOH Examples of incorrect and correct cause of death certification (March 2018)

28 min

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