CME : Your SA Journal of CPD - Volume 30, Issue 11, 2012
Volume 30, Issue 11, 2012
Author Bridget FarhamSource: CME : Your SA Journal of CPD 30 (2012)More Less
On the morning of Thursday 1 November I, along with several thousand other people, spent nearly 2 hours trying to enter the Two Oceans half marathon. The website was doomed to clog up because entries on that date were only open to those who had run the race before and were limited to 10 000. However, what really held it up was an enormous 13-page medical questionnaire that had to be filled out as part of the entry process. A similar questionnaire was introduced last year, but could be filled out later, once you had your entry. However, the race organisers (and the sports scientists involved) decided, in their wisdom, that this questionnaire was so important that it must now be part of the entry process.
Source: CME : Your SA Journal of CPD 30, pp 400 –401 (2012)More Less
'Emergencies occur everywhere, and each day they consume resources regardless of whether there are systems capable of achieving good outcomes.'
Low-income countries suffer the highest rates of every category of injury - from road traffic injuries to drowning; the highest rates of maternal death from acute complications of pregnancy; and the highest rates of acute complications of communicable diseases, including tuberculosis, malaria, and HIV. The rapidly growing prevalence of non-communicable diseases (such as cardiovascular and diabetic disease) has only increased the burden of acute illness, as patients with chronic disease in low-income countries also have the highest rates of mortality from acute complications. The World Bank's Disease Control Priorities in Developing Countries project estimates that 45% of deaths and 36% of disability in low-and middle-income countries could be addressed by the implementation of effective emergency care systems.
Source: CME : Your SA Journal of CPD 30, pp 401 –406 (2012)More Less
In South Africa there are a variety of animals that have the potential to inflict injuries. However, such injuries are relatively rare compared with dog bites, which are by far the most frequently encountered animal bites managed in our emergency centres. Many of the principles in the management of dog bites also apply to bites from other animals. Snake bite victims may require specific medical interventions such as the administration of antivenoms. For these reasons the focus of this article will be on dog bites and snake bites.
Author T.B. WelzelSource: CME : Your SA Journal of CPD 30, pp 406 –409 (2012)More Less
The casual observer may think that the topic of this article refers to the security available to minimise personal violence and theft, sadly speaking of a local bias. However, it refers to measures and systems that have to be put in place to minimise medical error and patient harm. The patient safety movement is now 13 years old, led by the publication of the US Institute of Medicine (IOM) Report To Err is Human. The basic premise at the time was that annually up to 98 000 Americans were estimated to have died because of medical error (although this calculation is still criticised by many as being too high or too low). Indeed, subsequent studies in a number of different healthcare environments put the adverse event rate as a percentage of admissions between 3% (Utah-Colorado Study and Harvard Medical Practice Study) and 17% (Quality in Australian Health Care Study).
Emergency management of drug abuse in South Africa - drug abuse remains both a global scourge and a significant social and medical problem in South AfricaAuthor Charl J. Van LoggerenbergSource: CME : Your SA Journal of CPD 30, pp 409 –413 (2012)More Less
Source: CME : Your SA Journal of CPD 30, pp 413 –415 (2012)More Less
More often than not major incidents and disasters result in a mass casualty situation, which places health services under added pressure. To deal with such a situation it is imperative to have a major incident plan for the pre-hospital and hospital sectors. The ability to 'do the most for the most' is central to dealing with such incidents. Triage is the universally accepted tool that allows health professionals to achieve this goal in a mass casualty situation.
Emergency point-of-care ultrasound applications - basic applications for the clinician performing bedside ultrasoundSource: CME : Your SA Journal of CPD 30, pp 416 –420 (2012)More Less
Clinicians who regularly manage critically ill and injured patients often lack the immediate clinical information that is essential to make correct clinical decisions. Emergency point-of-care ultrasound (EPCUS), performed by bedside clinicians, may provide some of this information, which will help in making the correct clinical decisions and improve overall patient outcomes.
Source: CME : Your SA Journal of CPD 30, pp 420 –423 (2012)More Less
Exposure to potentially toxic plants usually occurs in one of two ways. The first is where small children ingest parts of household plants such as leaves or seeds. Most of these exposures are of minimal toxicity because of the small quantity of material ingested. More serious poisonings involve adults who deliberately consume raw plant material or tea made from a plant for mind-altering or medicinal effects.
Emergency point-of-care ultrasound training, credentialing and accreditation : more about ... emergency medicineAuthor Hein LamprechtSource: CME : Your SA Journal of CPD 30, pp 423 –425 (2012)More Less
Emergency point-of-care ultrasound (EPCUS), performed by doctors, has recently become a popular skill that is used to enhance the accuracy of physical examination of patients. EPCUS provides additional, real-time, patient data which would not have been otherwise available. The effect is improved diagnostic accuracy and reduction in procedural error rates. Ultrasound technology is rapidly evolving. Machines are now more compact, portable, durable, and simpler to use, and provide improved image quality.
Author Paul BothaSource: CME : Your SA Journal of CPD 30, pp 424 –425 (2012)More Less
The causes of oral signs and symptoms could include medicine side-effects, trauma, autoimmune disease, nutritional deficiency, fungal infection (Fig. 1), premalignant disease (Fig. 2), oral carcinoma (Fig. 3), or sequelae of cancer treatment. What is the approach to the management of such patients?
Source: CME : Your SA Journal of CPD 30, pp 425 –430 (2012)More Less
This is the second in our series of clinical articles that discuss everyday presentations. Each emphasises practical aspects of team-based care that are relevant for general practitioners, specialists and paramedical professionals. Disorders arising in blood and bone marrow result in some of the commonest presenting symptoms and signs. A careful history and physical examination, complemented by rational use of laboratory tests, provides the clinical basis for a working diagnosis. If further investigation is needed into bone marrow or plasma, then supplementary imaging and radionuclide technology may be necessary under the guidance of an experienced haematologist.
Source: CME : Your SA Journal of CPD 30, pp 430 –431 (2012)More Less
A 68-year-old woman presented with stupor (Glasgow coma score 11/15), severe sinus bradycardia (36 beats/minute) and bradypnoea (6 breaths/minute), after being bed-bound for a prolonged period owing to extreme lethargy. She was taking 200 mg amiodarone twice daily. The amiodarone had been initiated 9 months previously for arrhythmia control post-myocardial infarction.
Author Michael CarterSource: CME : Your SA Journal of CPD 30 (2012)More Less
Author Chris BatemanSource: CME : Your SA Journal of CPD 30, pp 434 –436 (2012)More Less
International - UK doctors to have 5-yearly appraisals
Africa - Nigerians splurge on medical tourism
South Africa - Health claims rise to R1.4 billion
South Africa - Gauteng health department 'incompetent'
South Africa - Give central hospitals more autonomy - Scopa
South Africa - Obesity - a growing issue in SA
South Africa - SA scientists in HIV breakthrough
Source: CME : Your SA Journal of CPD 30 (2012)More Less