Emergency medicine and general practice

Emergency Medicine and Immediate Medical Care are relatively new specialties. In Malta, there is quite a considerable area of overlap between these specialties and general practice. Indeed, the family physician is confronted with some sort of medical emergency quite regularly. The brief of this article is to go through recent developments in Emergency Medicine as applied to General Practice. The areas considered are Basic Life Support, Head Injury, Asthma, Anaphylaxis, Community Acquired Pneumonia, Burns and Controlled Hypotensive Resuscitation. Whenever possible, distinct practical guidelines will be suggested as an aid in the clinical management of emergency situations which the family physician may encounter. This overview of new developments is by no means comprehensive but serves to highlight the increasing importance given to the role of the first-line medical practitioner in the emergency situation.peer-reviewe

Control of General Medicine Supply Using Critical Index ABC Analysis at Department of Pharmacy Siti Khadijah Islamic Hospital Palembang

Background : Department of Pharmacy Siti Khadijah Islamic Hospital serves all the needs of outpatient and inpatient care unit. Control of medicine management at Department of Pharmacy Siti Khadijah Islamic Hospital is not really good enough. It can be seen from a gap of medicine supply at certain time. Methods : This research is a descriptive study. The population at this research about 1202 items of general medicine and the sample about 180 items of general medicine. The critical values ​​of general medicine with check list form while the secondary data obtained from data report of the Department of Pharmacy Siti Khadijah Islamic Hospital. Results : By using the ABC Critical Index Analysis, the results shows that from 180 items of medicine, 37 items are group A, 96 items of medicine classified as group B, and 47 items of medicine are group C. As for control of inventory of the planning, procurement, storage and distribution to the group A critical index general medicine done at the Department of Pharmacy Siti Khadijah Islamic Hospital have not been going well, it can be seen from the inappropriate method of consumption used to calculate the number of medicine needs, the calculation of the number of procurement and the time of procurement is only based on estimation and also some items of medicine were still stock out and over stock during the period of January to March 2012. Conclusion : Department of Pharmacy Siti Khadijah Islamic Hospital needs to apply ABC Critical Index method in setting priorities for the planning, procurement and supervision of medicine use to make it more effective and efficient which aims to prevent a stock out or over stock inventory

General Practitioners' perceptions of the route to evidence-based medicine: a questionnaire survey

Objectives: To determine the attitude of general practitioners towards evidence based medicine and their related educational needs. Design: A questionnaire study of general practitioners. Setting: General practice in the former Wessex region, England. Subjects: Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied. Main outcome measures: Respondents' attitude towards evidence based medicine, ability to access and interpret evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine. Results: Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases and 17% to the world wide web. Most had some understanding of the technical terms used. The major perceived barrier to practising evidence based medicine was lack of personal time. Respondents thought the most appropriate way to move towards evidence based general practice was by using evidence based guidelines or proposals developed by colleagues. Conclusion: Promoting and improving access to summaries of evidence, rather than teaching all general practitioners literature searching and critical appraisal, would be the more appropriate method of encouraging evidence based general practice. General practitioners who are skilled in accessing and interpreting evidence should be encouraged to develop local evidence based guidelines and advice

The Use of Telemetry Monitoring Among General Medicine Patients

Objective: To determine why and when general medicine non-ICU patients are upgraded from a non-telemetry level of care to telemetry monitoring at Thomas Jefferson University Hospital (TJUH). Comparison of the reasons for initiation of continuous ECG monitoring with the AHA and ACC guidelines would provide a greater understanding of the applicability of these recommendations to non-ICU general medicine patients. This information can provide guidance to identify areas of intervention to decrease inappropriate and/or overutilization of telemetry. The ultimate goal is to identify general medicine patients who are likely to benefit from continuous ECG monitoring, without negatively affecting clinical outcomes for those who do not receive cardiac monitoring.https://jdc.jefferson.edu/patientsafetyposters/1025/thumbnail.jp

New Horizons in Psychiatry

Psychiatrists have long held that there should be more psychiatry in general medicine, and the nonpsychiatric physicians have said that there should be much more medicine in psychiatry. Both groups have been perfectly correct and are being told by the consuming population that there must be more sociology in each of them. The future psychiatrist must and will work with his colleagues in medicine, not to achieve a utopia, but at least to approach this desirable situation in some degree

Aspects of general medicine

Horizons in Medicine is a series produced annually by the Royal College of Physicians. Volume 19 is based on their Advanced Medicine Conference held in 2007 and offers updates on a wide range of topics in clinical medicine. This 'review of reviews' covers developments described in a selection of chapters. The chapters summarised include: Contemporary management of acute myocardial infarction; Imported infectious disease emergencies; New therapies in the management of type 2 diabetes; Stress and adrenal insufficiency; Making sense of a 'funny thyroid function test'; Myeloproliferative disorders: management and molecular pathogenesis; Drug allergies; Osteoporosis; Rheumatoid arthritis; Understanding migraine from bench to bedside.published_or_final_versio