Sun.Feb 02, 2025

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A Comprehensive Guide to Surgical Clerking

Mind The Bleep

This guide is designed to help you identify the key areas you need to focus on when clerking a surgical patient. There are several differences when compared to clerking a medical patient, namely getting a more extensive surgical past medical history, examination and assessing frailty. Your clerking needs to be succint, pertinent and clear. Presenting Complaint This needs to be clear and brief – a headline to tell any reader why that patient has presented: Good example: “1/7 colicky R

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Sometimes a patient is fortunate to have a cardiac arrest

Dr. Smith's ECG Blog

Written by Pendell Meyers A man in his 60s presented with acute chest pain. Here is his triage ECG: What do you think? There is sinus rhythm with clear LVH. Leads V5-6 are suspicious for upright, enlarged T waves that are possibly inappropriate for the QRS complex, especially V6. But without a baseline for comparison, it would be difficult for me to say that it is specific and diagnostic for OMI.

EKG/ECG 72
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Dealing with difficult colleagues

Mind The Bleep

This is a tricky area to cover as it can be challenging to us both personally and professionally when things dont go well with a colleague, particularly when we know that this might impact patient care and/or our own mental health. The longer these negative interactions go on, the more likely they are to significantly impact on outcomes for our patients, our colleagues and ourselves.

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Winter Break

Pediatric Education

PediatricEducation.org is taking a short break. The next case will be published on 2/10/25. In the meantime, please take a look at the different Archives and Curriculum Maps listed at the top of the page. We appreciate your patronage, Donna DAlessandro and Michael DAlessandro, curators.

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Breaking Bad News

Mind The Bleep

As a resident doctor, you will have face situations where you have to convey potentially distressing information, whether it is explaining a diagnosis or blood results to a patient or giving difficult news to relatives. Breaking bad news well is an essential communication skill which can strengthen the relationship between a patient and a doctor and create an environment where the patient and/or their families feel respected and supported.

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Randomize NIH grant giving

Sensible Medicine

A pause in NIH study sections has been met with fear and anxiety from researchers. At many universities, including mine, professors live on soft money. No grants? If you are assistant professor, you can be asked to pack your desk. If you are a full professor, the university slowly cuts your pay until you see yourself out. Everyone talks about you afterwards, calling you a failed researcher.

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Referrals

Mind The Bleep

Often one of the scariest things you can do as you will most likely be speaking to a more senior colleague in an unfamiliar speciality. However, as an F1, you may well know the patient best and therefore you may be best placed to refer the patient. Our Webinar Introduce yourself and say on whose behalf you are making the referral Remember, you hold all the information about the patient and are therefore in the driving seat Use the SBAR approach and you wont go far wrong Know why you are referrin

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Clerking Patients: A few tips

Mind The Bleep

Here we assume you know the basics , and instead we focus on the common pitfalls with tips on how to be safe & well reasoned. Not all FY1s have the opportunity to clerk patients but the underlying principles are of great value if youre doing an FY1-led ward round. Be Thorough The expectation is that you are slow and thorough if you rush you can make mistakes & you end up spending more time worrying than seeing patients.

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Microbiology Discussions

Mind The Bleep

A lot of your time as an FY1 will be spent on the phone to various other specialities. Youll come across patients with infections in all your rotations, and – if they dont present with one – it may develop during admission. So, its a good idea to make talking to Microbiology as productive (and painless!) as possible. Calling micro for advice Calling other specialities to ask advice was always a palm-sweating, tongue-tying experience for me.

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Discharge Planning

Mind The Bleep

It is important for resident doctors to understand what the discharge planning process involves so you can have an active role in multidisciplinary team meetings. This article focuses on discharging home with an appropriate package of care but discharge planning also involves discharging to different types of homes ( which is discussed in another article ).