Main description:

The multidisciplinary sub-specialty of Urgent Medical Care plays an increasingly important role in meeting the growing demands on the NHS. This is the first and only book in the UK specifically designed for clinicians preparing for urgent care postgraduate qualifications.

Notes in Urgent Care brings together guidance, research and relevant clinical material in an easily accessible format. It addresses both management (operational and organisational) and clinical areas including emergency, time-critical conditions and symptom-related presentations.

Written by Dr Martin McGrath, a General Practitioner, Honorary Professor, urgent care clinician and clinical director of one of the country's largest primary care networks, this book will be useful for all clinicians working in urgent, unscheduled, remote and rural environments.

Suitable as a study aid for the Royal College of Surgeons of Edinburgh's Diploma in Urgent Medical Care
Clinical information condensed into a concise, easily accessible and relevant format
Urgent conditions broken down by specialty
Useful tips for working in urgent medical care systems, using technology, risk management and human factors

Contents:

Acknowledgements

Symbols and abbreviations

Foreward

PART I - MANAGEMENT

Working in Urgent Medical Care Systems

The development of urgent care systems - a brief history

The development of urgent care systems - challenges

The development of urgent care systems - evolving solutions

Alternative urgent care models

The evolution of urgent care workforces

Patient choice and behaviour

UUC operational environments

NHS 111 services

GP out of hours services

Working in multi-disciplinary teams

999 call handling and dispatch

(The functions of urgent care)

The characteristics of good and bad urgent care services

Working effectively with acute and urgent care services

Providing support to urgent care staff

Supporting workers after traumatic events

Using Technology in Urgent Medical Care

Definitions and meanings

Drivers for change - overview

Drivers for change - system

Drivers for change - individual

Future technology

Relevance of health technology in UUC settings

What is an Urgent Treatment Centre?

Example near-patient investigations

Use of PPE

Indwelling catheters

Hand decontamination

Remote care and monitoring

TeleMedicine

Managing Safe Dispositions

Role and responsibilities of the referring clinician

Factors influencing referral decisions

Factors influencing risk-based decision-making

Decision-making and referral in remote consultation

Remote consultations - safeguarding considerations

Supportive care and avoiding admissions

Compulsory mental health admission

The Mental Capacity Act (MCA) 2005

Assessment of capacity

Deprivation of liberty safeguards (DoLS)

Child safeguarding

Adult safeguarding

Raising concerns

Whistle blowing

Prevent/Channel

Domestic violence and abuse

Human trafficking

Modern slavery

Female genital mutilation

Patient transfer and transport

Role of clinicians in transfers

The ambulance response programme

Risk Management and Urgent Care Preparedness

Hazard and risk

Risk management and system design in the context of urgent care

Learning from significant event analysis (SEA) and serious untoward incidents (SUIs)

Principles of emergency preparedness, response and recovery

The role of urgent care services in relation to a major incident

Management of major incident situations

The psychological needs of those involved in a major incident

Business continuity relevant to urgent care services

Human Factors

Human factors in healthcare and patient safety

The swiss cheese model

The SHEEP model

The WHO surgical safety checklist

Crew resource management

Cognitive bias

Decision-making in urgent care

Communication within and between teams (CHANGE)

Teamworking

Leadership

Bad leadership

Managing fatigue and stress

Error investigation and management

Root cause analysis

Operational Performance

Local and national operational guidance

Settings for patient care

Urgent Treatment Centres

Professional roles in urgent care

Communication with colleagues and patients

Communication with routine healthcare providers

Consultation models

Monitoring the delivery of patient care

Targets

Applying principles of equality and diversity

PART II - CLINICAL

Emergency and Time-Critical Conditions

Anaphylaxis

Cardiac arrest

Choking

Meningitis

Sepsis

Status epilepticus

Unconsciousness

Symptom Management

2WW considerations

Acute abdominal pain

Chest pain

Collapse

Haemoptysis

Hyperventilation

Shortness of breath

Breast

2WW considerations

Breast lump

Mastitis

End of Life Care

General considerations

Managing EOL symptoms

Cardiology

Angina

Acute coronary syndromes - unstable angina / NSTEMI

Acute coronary syndromes - STEMI

Aortic dissection

Brady and tachy-arrythmias

Electrical Injury

Left ventricular failure / pulmonary oedema

Pericarditis

Uncontrolled atrial fibrillation

Uncontrolled hypertension

Dental

Acute dental and gum Infection

Dermatology

Abscess

Cellulitis

Ear Nose and Throat

Bell's palsy

Loss of hearing

Otitis externa

Otitis media

Sinusitis

TMJ dysfunction

Tonsillitis

Vertigo

Endocrine, Haematology & Metabolic

2WW considerations

Addisonian crisis

Hyperglcaemic crisis

Hypoglycaemia

Hyperkalaemia

Hypokalaemia

Hypernatraemia

Hyponatraemia

Thyrotoxic crisis

Gastroenterology and General Surgery

2WW considerations

Acute appendicitis

Acute cholecystitis

Acute pancreatitis

Anal pain

Constipation

Diverticulitis

Gastroenteritis

GI bleed - lower

GI bleed - upper

Haemorrhoids

Hernia

Intestinal obstruction

Peptic ulcer

Mental Health

Mental health assessment

Mental health symptoms and signs

Psychological therapies

Anxiety

Other anxiety-type disorders

Chronic stress

Depression

Drugs for treating depression

Psychosis

Schizophrenia and mania

Acute delirium

Dementia

Eating disorders

Other psychological conditions

Musculoskeletal including Trauma

Olecranon bursitis

Neurology

2WW considerations

Acute confusional state / delerium

First fit

Headache

Migraine

Status epilepticus

Stroke / CVA

Subarachnoid haemorrhage

TIA

Obstetrics and Gynaecology

2WW considerations

Abnormal vaginal bleeding

Ectopic pregnancy

Gynaecological pain

Pre-eclampsia

Menorrhagia

Vaginal bleeding in pregnancy

Vaginal discharge

Ophthalmology

Blepharitis

Conjunctivitis

Corneal abrasions and ulcers

Peri-orbital cellulitis

The red eye

Respiratory

2WW considerations

Acute asthma - moderate

Acute asthma - life threatening

COPD

Pleural effusion

Pneumonia / LRTI

Spontaneous pneumothorax

Urogenital

2WW considerations

Acute epididymitis / epididymo-orchitis

Acute prostatitis

Balanitis

Renal colic

Testicular torsion

Urinary retention

Urinary tract infection

Vascular

Acute limb ischaemia

Deep vein thrombosis

Pulmonary embolism

Ruptured abdominal aortic aneurysm

PART III - THE DIPLOMA IN URGENT MEDICAL CARE

Outline

Example single best answer (SBA) questions

Example structured oral questions

BIBLIOGRAPHY