Clinical Conversations

Dr Jonathan Bardgett interviews Prof Najib Rahman about the assessment and management of patient's presenting with pleural effusion.

Professor Rahman runs the Oxford Pleural Unit and Directs the Oxford Respiratory Trials Unit. He is co-chair of the BTS Pleural Guidelines 2021, Chair of the BTS Pleural Intervention Committee, and Chair of multiple ERS guidelines on pleural disease.

British Thoracic Society - Guidelines

https://www.brit-thoracic.org.uk/quality-improvement/guidelines/

American Thoracic Society - Guidelines

https://doi.org/10.1513/AnnalsATS.201809-620CME

My Pleural Effusion

https://mypleuraleffusionjourney.com/

Training Standards for Thoracic Ultrasound

http://dx.doi.org/10.1136/bmjresp-2019-000552

RAPID Score for Pleural Infection

https://www.mdcalc.com/rapid-score-pleural-infectionl

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Jonathan Bardgett talks to Dr Ingrid Hoeritzauer about functional neurological disorders, how to diagnose them and discuss the positive features necessary to make a diagnosis with patients and their families.

Resources:

Recognising and explaining functional neurological disorder

https://www.bmj.com/content/371/bmj.m3745/infographic

https://www.neurosymptoms.org

https://twitter.com/FndPortal

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Rachel Sutherland interviews Prof Mark Strachan about how to approach the hyperglycaemic patient who presents in the acute receiving unit.

Professor Mark Strachan is a Consultant Physician in Endocrinology, Diabetes and Acute Medicine at the Western General Hospital, Edinburgh and Honorary Professor of the University of Edinburgh.

Dr Sutherland is a Consultant in Stroke and General Medicine in the South East of Scotland. She has an interest in integrated, real time analytics and spent some time outside of medicine working as a medical informaticist. She is a passionate advocate for Flexible working and training for doctors.

Feedback and suggested future topics are very welcome, please contact us via email at: [email protected]

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Rachel Sutherland talks to Prof Mark Strachan about C-Peptide, and how it can be used to help identify the underlying cause of diabetes.

Professor Mark Strachan is a Consultant Physician in Endocrinology, Diabetes and Acute Medicine at the Western General Hospital, Edinburgh and Honorary Professor of the University of Edinburgh.

Feedback and suggested future topics are very welcome, please contact us via email at: [email protected]

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Claire Gordon talks about 'Leadership and management in the Acute Medical Unit' with Dr Jonathan Bardgett. Dr Gordon is an Acute Medical Consultant working South East Scotland. She shares her experience of leadership and management during the COVID-19 pandemic and discusses working with Acute Internal Medicine.

Recording date: 15 February 2021

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Xan Hughes (pronouns they/them) talks to Dr David Ryan (pronouns he/him) about being an openly transgender doctor working in the NHS. The topics covered include an introduction to some common terminology relevant to talking about trans healthcare and about how easy changes to practices can help both trans colleagues and patients have a better experience.

Dr Xan Hughes, is a Foundation Year Two (FY2) doctor working at a large London teaching hospital. Their research interests include barriers to healthcare and widening access especially to preventative care.

Recording date: 14 February 2021

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Dominique Baker, senior Registrar in Obstetrics and Gynaecology in the South East of Scotland Deanery gives us an overview of acute medical problems in pregnancy, we talk about the clinical assessment and multidisciplinary management of these patients.

Resources

Maternity Early Warning Score: https://ihub.scot/media/5308/national-mews-chart_web.pdf

Prescribing in pregnancy(BUMPS: https://www.medicinesinpregnancy.org

Recording date: 1 February 2021

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr James Tiernan, a Respiratory Consultant in South East Scotland, talks about the investigation and management of acute pulmonary embolism and the follow up of this disease in the current COVID-19 pandemic.

PE Wells Score: https://www.mdcalc.com/wells-criteria-pulmonary-embolism

Simplified Geneva Score: https://www.mdcalc.com/geneva-score-revised-pulmonary-embolism

NICE Guidelines: https://cks.nice.org.uk/topics/pulmonary-embolism/

Recording date: 18 January 2021

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Jonathan Bardgett and Dr Francesca Moroni discuss the importance of recognising and treating malnutrition in the acutely ill patient. This episode offers practical advice on assessing malnourished patients and provides an overview on available interventions from simple dietary adjustments to artificial feeding. Particular interest is posed on recognising patient at risk of refeeding syndrome and how to prevent it. A multidisciplinary approach to the malnourished patient is key in the successful management of malnutrition with specific focus on the fundamental role of the dieticians.

Dr Moroni touches upon different tubes and feed modalities and practical advice on managing high NG aspirates. A brief mention on parenteral nutrition can stimulate the listener to read more about it. The extreme malnutrition scenario is offered by patients with anorexia nervosa who require admission in acute medicine. These patients should be treated with extreme caution and involvement of gastroenterologist, dietician and psychiatrist should be priority.

MUST Tool: https://www.bapen.org.uk/screening-and-must/must/introducing-must

Reefeeding risks: National Institute for Health and Care Excellence. Nutrition support in adults. Clinical guideline 32: https://www.nice.org.uk/guidance/CG32

Moroni F, Metcalfe E, McKinlay A. Assessing the nutritional status of an acutely ill patient. BMJ 2017; 357 doi: https://doi.org/10.1136/sbmj.j1448 (Published 31 May 2017)

MARSIPAN Guidelines: https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr189.pdf

Recording date: 4 January 2021

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).

Dr Addy McLeod and Dr Paul Coulter discuss the importance of resilience training and mental wellbeing for a successful career. Dr Coulter shares his experience of a holistic approach to building resilience and confidence.

Dr Addy McLeod is a senior geriatrics registrar in the North East Deanery and Chair of the Trainees and Members' Committee at the Royal College of Physicians of Edinburgh.

Stories from Patient Voices open workshops

http://www.patientvoices.org.uk/pilgrim.htm

Help me! I'm only human... | Adam Crizzle | TEDx

https://www.youtube.com/watch?v=w7JSDvJh23M

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This podcast is from the Trainees & Members' Committee (T&MC) of the Royal College of Physicians of Edinburgh (RCPE).