This month dives into the intriguing use of serum lactate for diagnosing seizure types, revealing its diagnostic power but acknowledging its limits. The discussion tackles the serious issue of non-fatal strangulation, emphasizing the need for sensitivity and thorough assessments in emergency settings. Team dynamics also take the spotlight, showcasing how familiarity within medical teams can significantly boost performance and communication. Plus, there’s a look at new articles to enhance ongoing professional development in emergency care.
The podcast discusses the potential of serum lactate levels to differentiate between epileptic seizures and other causes of loss of consciousness.
Guidelines for managing non-fatal strangulation highlight the serious physical and psychological implications, emphasizing the need for thorough assessments and appropriate referrals.
Research reveals that familiarity within medical teams significantly improves communication and performance, underscoring the importance of stable team dynamics in healthcare.
Deep dives
Challenges of Team Familiarity in Healthcare
Working with unfamiliar teams can lead to discomfort, particularly highlighted by the changes in nursing staff during the COVID pandemic. Increased turnover has necessitated a longer acclimatization period for consultants and existing staff to familiarize themselves with new team members. The speaker emphasizes that getting to know colleagues and building trust is essential for improving team dynamics and patient care. This experience underscores the importance of stable teams in high-stakes medical environments like emergency departments.
Hot Showers and Cannabinoid Hyperemesis Syndrome
An email shared insights about cannabinoid hyperemesis syndrome (CHS) and the transient relief that patients experience from hot showers during episodes of pain and vomiting. A case example involved a patient whose excessive hot shower use led to a significant gas bill, bringing the situation to the attention of a family member. Furthermore, the discussion pointed out how showing patients relevant information from internet searches can aid in their acceptance of the diagnosis and encourage abstaining from cannabis. This highlights the importance of educating patients about their conditions and the treatment process.
Differentiating Seizures using Lactate Levels
The potential use of lactate levels in differentiating between seizure-related loss of consciousness and other causes was discussed, based on a systematic review and meta-analysis. While elevated lactate levels are noted to rise post-generalized seizures, the findings suggest a lactate level of approximately 2.5 as potentially useful for distinguishing seizures from non-epileptiform movements. However, there was no significant difference in lactate levels between patients with generalized seizures and those with psychogenic non-epileptic seizures. Overall, lactate should be utilized as one piece of clinical information rather than a definitive diagnostic tool.
Addressing Non-Fatal Strangulation in Healthcare
The podcast delves into guidelines for managing patients who have experienced non-fatal strangulation, emphasizing the serious implications of these cases. Statistics reveal alarming links between non-fatal strangulation and increased risk of homicide, especially in intimate partner violence scenarios. The discussion highlights crucial clinical assessments, including attention to both psychological and physical injuries, and the importance of appropriate referrals to domestic violence support systems. The guideline also encourages healthcare professionals to retain a high index of suspicion for potential injuries in these patients, even in the absence of immediate physical signs.
Impact of Team Familiarity on Clinical Performance
A randomized control trial evaluated the effects of familiar team dynamics on communication and clinical performance among medical interns. The results indicated that interns working in stable teams experienced less stress and improved performance in simulations compared to those constantly rotated among unfamiliar teams. For instance, interns in familiar settings were contacted less frequently by nurses for tasks, suggesting increased trust and collaboration. This highlights the broader implications for medical training, advocating for the integration of team-building practices to enhance overall clinical outcomes.
This month for the April 2023 RCEMLearning podcast we've got two New in EM segments looking at using lactate to identify epileptic seizures and the impact of familiarity on performance. Becky and Chris delve into a guideline for non-fatal strangulation, and then finally we bring you three new articles for your CPD in New Online. If you'd like to email us, please feel free to do so here.
(03:15) New in EM - Using lactate to diagnose epileptic seizures
