MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'awkward'. Sat, 03 Sep 2011 03:02:22 +0100 http://www.medworm.com/index.php?rid=4653342&cid=t_205923_88_f&fid=35612&url=http%3A%2F%2Ftheknifeman.blogspot.com%2F2011%2F03%2Finterlude-referral-politics-2.html So: the last of the epic tales of my on call.I knew I'd be late on the floor; 2 down and busy, no way was I getting off on time. Half two in the morning is close to my limit. If there are sick patients, well, strap on when it seems apt, but if its just busy...As I was preparing to escape, I was introduced o one of my absolute favourite ED dilemmas. The 'problem' patient that no-one will admit, or discharge. Typically, this will be someone well known to one service, or more than one, with a chronic problem. They inevitably attend out of hours, with a flare of their problem, usually requiring strong painkillers.In this case, the problem was abdominal pain. Surgical review diagnosed "not a surgical problem' with a plan of "refer medics'. But of course, the surgeon couldn't possible make that ... The KnifeMan blogs http://www.medworm.com/rss/comments.php?id=4653342 Tue, 29 Mar 2011 13:08:00 +0100 4653342 http://www.medworm.com/index.php?rid=4642605&cid=t_205923_88_f&fid=35612&url=http%3A%2F%2Ftheknifeman.blogspot.com%2F2011%2F03%2Finterlude-referral-politics.html Ah, the joy of the referral.Times have changed. The all powerful target means less time for us, in the ED to reach a diagnosis; often the decision to refer for admission is based on a lack of a diagnosis, coupled with the fact that the hospital says I can't stop and think.And so, the soft referral. I like to think that most of my referrals are kosher, and if I'm not sure, I'm honest about it. But sometimes, I just don't know what's wrong with a patient, but I'm pretty certain they need longer obs than I can offer in the ED, and maybe more tests. (More tests! The answer to everything!)I had just a conundrum recently, and was given a hard time by the MedReg. Not necessarily inappropriately; I really couldn't figure out what was afoot, but I tried to be honest about that, and why I though the... The KnifeMan blogs http://www.medworm.com/rss/comments.php?id=4642605 Mon, 28 Mar 2011 09:44:00 +0100 4642605 http://www.medworm.com/index.php?rid=3003766&cid=t_205923_88_f&fid=35612&url=http%3A%2F%2Ftheknifeman.blogspot.com%2F2009%2F11%2Fmanagement-flail.html I hate being stuck in the middle.It happens a lot, mostly because many of my colleagues still regard the ED docs as non-specialist, and think we will be their scut-monkeys. Old habits die hard, an all that.Recently, I was presented with a challenging patient. A young woman, with a non-specific history of headaches, who had suddenly gone bananas. I apologise for the use of technical jargon. She had rapidly become delirious, with a fluctuating conscious level, and was spouting mostly gibberish.Part of the work up was to include a CT scan, and we doubted our ability both to transfer her safely, and to convince her to lie still. ITU helped out with both of these things, but then pretty much washed their hands.Her scan was normal, but bloodwork suggested and infective process and acute renal fa... The KnifeMan blogs http://www.medworm.com/rss/comments.php?id=3003766 Thu, 12 Nov 2009 13:09:00 +0100 3003766 http://www.medworm.com/index.php?rid=2389930&cid=t_205923_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F06%2Fschizophrenia-and-driving%2F When someone is recovering from a severe mental illness like schizophrenia — a disorder that can seriously alter one’s perception of reality — sometimes awkward situations come up. Dr. Ron Pies, a contributor to Psych Central, discusses just such a case in The New York Times yesterday. His patient, recovering from schizophrenia and doing quite well, wanted Dr. Pies to sign off on his application to get a driver’s license: While schizophrenia may increase the likelihood of an accident, research in the 1980s by Dr. Russell Noyes suggested that, among patients with psychiatric disorders, those with alcoholism and antisocial personality traits accounted for most of the risk. The Utah Department of Public Safety asserts that most people under active treatment for schi... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2389930 Wed, 06 May 2009 19:49:30 +0100 2389930 http://www.medworm.com/index.php?rid=2389933&cid=t_205923_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F05%2Fwhere-did-mommy-go%2F There is a controversial book on the Australian market called, Where Did I Really Come From? which explains how to answer those most awkward questions children tend to ask, only with a slight updated twist. Instead of the traditional double-speak of flying storks, planting seeds and cabbage patches (which led me to believe my father’s gardening shed was a Den of Iniquity), it’s a realistic account of where some children really do come from. The book includes sections about lesbian Mums, gay men, IVF babies and assisted conception. The author, Narelle Wickham, says the book is just trying to let children know that there are many ways to conceive a child, all of which are normal. But, according to Focus On The Family spokeswoman Deb Sorensen, it devalues the traditional family unit. In ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2389933 Tue, 05 May 2009 17:00:36 +0100 2389933 http://www.medworm.com/index.php?rid=2342104&cid=t_205923_177_f&fid=38134&url=http%3A%2F%2Fbabybound.wordpress.com%2F2009%2F04%2F12%2Fthis-is-so-much-harder-than-it-looks%2F Happy Easter and all that crap. Today was hard.  Really really hard.  I went to my parents this weekend for the holiday and everyone today asked me:  “Hey where is Mark”.  To which I replied:  “O he’s sick”.  Which I pride myself on being honest about because frankly, he is sick.  In the head.  My grandma pushed further and wanted to know if it was related to his hand, and if he was ok, and if I had talked to him this morning, and if I was bringing home some of the food for him, and if I was worried about him.  Ouch.  That hurt.  I’m barely holding it together as it is. Then while we were all sitting around the table, the whopper of a stabbing hit me right between the eyes when I wasn’t expecting it.  And from a source that I would neve... B a b y B o u n d blogs http://www.medworm.com/rss/comments.php?id=2342104 Sun, 12 Apr 2009 23:22:13 +0100 2342104 http://www.medworm.com/index.php?rid=1862719&cid=t_205923_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F10%2F08%2Ffacebook-friends-poor-social-adjustment%2F In a recent study of 70 undergraduate students at Assumption College in Massachusetts, researcher Maria Kalpidou found that the number of Facebook friends you have can predict social adjustment to college. Freshmen with 200 or more friends scored with lower levels of self-esteem and personal and academic adjustment than freshmen with less than 200 friends. That’s right — the more “friends” you have on Facebook, the less likely you are to have, well, actual friends. These effects wore off over time, however, as upper-class students surveyed with 200 or more friends showed higher levels of social adjustment and enthusiasm for their school (”school spirit”). Kalpidou suggested this may be due to upper-class students using Facebook more effectively as a way... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1862719 Wed, 08 Oct 2008 14:02:57 +0100 1862719