tag:blogger.com,1999:blog-2482732367812174734.post4533781523704878544..comments2024-02-28T08:42:52.675+00:00Comments on The Junior Doctor: Life-long learning #2Dr Michael Andersonhttp://www.blogger.com/profile/05340927185641717290noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-2482732367812174734.post-72019246643123956732007-11-27T16:46:00.000+00:002007-11-27T16:46:00.000+00:00In these days of technological wizardry and monito...In these days of technological wizardry and monitoring it is possible to rely too much on machines.<BR/><BR/>In the Ambulance Service we are taught to read the patient as well as the machine.<BR/><BR/>Examples: Blood Glucometer reading saying 8.0 when patient is sweating+++ confused++ with history of diabetes and recent exertion with missed meals. I gave Glucagon and patient recovered within 10 mins although subsequent bm at A/E said 4.<BR/><BR/>BP readings in their boots incompatible with consciousness. I always take a manual reading with my steth if the automatic bp is playing up.<BR/><BR/>ECG displaying NSR whilst patient showing all S&S of MI. 12 leads have made it easier but still difficult to see posterior MI,s.<BR/><BR/>My wife complains that I twitch and shake a lot in bed after a shift at work...could the basis for some research somewhere.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2482732367812174734.post-80959580294925270342007-11-15T21:31:00.000+00:002007-11-15T21:31:00.000+00:00Fair play - and that one's certainly a good point ...Fair play - and that one's certainly a good point to learn.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2482732367812174734.post-59404075510094001862007-11-13T20:08:00.000+00:002007-11-13T20:08:00.000+00:00Anon - fair enough, but I suppose the point the co...Anon - fair enough, but I suppose the point the consultant was making is that to trust your clinical skills. They will guide you through when technology fails.Dr Michael Andersonhttps://www.blogger.com/profile/05340927185641717290noreply@blogger.comtag:blogger.com,1999:blog-2482732367812174734.post-27154920900293141992007-11-12T20:36:00.000+00:002007-11-12T20:36:00.000+00:00Good theory, but discredited! Radial disappears be...Good theory, but discredited! Radial disappears before femoral before carotid as BP drops, but exact limits vary from patient to patient. I think your consultant was lucky this time.<BR/><BR/>There was a paper about this about four years ago that showed the exact numbers were pretty variable. Still, impressive when it works.<BR/><BR/>MichaelAnonymousnoreply@blogger.com