Davidson's Foundations of Clinical Practice Book

Preface v

Contributors vi

Section 1 Basic principles of patient care

1 Initial assessment and emergency management 1

General history and examination 1

Assessment of the acutely ill patient 8

Cardiac arrest management 11

2 Use of equipment and procedures 18

Procedural competence 18

The sterile field 19

Local anaesthetics 22

Venepuncture and cannulation 25

Blood cultures 27

Injections and infusions 29

Arterial blood gas sampling 31

Arterial line insertion 32

Urinary catheterization 34

Lumbar puncture 37

Pleural aspiration 38

Chest drain insertion and management 40

Nasogastric tube insertion 44

PEG tube and drain insertion 45

Ascitic tap and drain insertion 46

Joint aspiration and injection 48

Central line insertion 50

Temporary cardiac pacing 54

Defibrillation and electrical cardioversion 58

Wound closure and dressings 61

Suturing 63

ECG recording 65

Oxygen delivery 66

Nebulizers 67

Peak flow and spirometry 68

3 Interpreting tests 70

Laboratory tests 70

ECG interpretation 78

Peak flow and spirometry 89

Radiological tests 90

Chest X-rays 94

Abdominal X-rays 101

4 Drugs and prescribing 106

General prescribing 106

Common prescribing 107

Common interactions 111

Prescribing errors 113

Drug reactions 114

Dose calculation 115

Drug monitoring 118

Drug use in special circumstances 119

Prescribing fluid and blood 122

Section 2 Symptoms and related acute presentations

5 Cardiac and chest 125

Chest pain 125

Arrhythmias 132

Breathlessness 139

6 Abdominal 159

Acute abdominal pain 159

Diarrhoea, vomiting and constipation 169

Gastrointestinal bleeding 174

Abnormal liver function178

Nutrition 183

Haematuria and urinary retention 185

7 Endocrine, electrolyte and renal 187

Diabetes mellitus 187

Thyroid and adrenal problems 197

Electrolyte imbalance 202

Renal dysfunction 209

8 Neurological and psychiatric 216

The unconscious patient 216

Headache 218

Fits and faints 220

Stroke 223

Focal neurology 226

Falls and immobility 231

Delirium and alcohol withdrawal 233

Acute psychosis 235

Self-injury and self-poisoning 237

9 Sepsis, shock and trauma 242

Sepsis and infection 242

Fluid balance, shock and anaphylaxis 249

Major trauma 254

Fractures and minor trauma 259

Acute leg pain 270

Wounds and burns 272

Section 3 Specialties and cancers

10 Specialty acute presentations 276

Haematological 276

Rheumatological 283

Dermatological 292

Ear, nose and throat 308

Ophthalmic 313

Obstetric 318

Gynaecological 331

Paediatric 335

Surgical lumps 343

11 Cancers and palliative care 349

Performance status and quality of life 349

Lung cancer 350

Breast cancer 353

Colorectal cancer 355

Oesophageal cancer 357

Stomach cancer 359

Pancreatic cancer 360

Ovarian cancer 361

Cervical cancer 363

Endometrial cancer 364

Prostate cancer 365

Bladder cancer 367

Renal cancer 368

Testicular cancer 369

Leukaemia 370

Lymphoma 373

Myeloma 375

Palliative care 376

Section 4 Everyday life as a junior doctor

12 On the ward 383

Time and 'take' management 383

Verbal communication 385

Written communication 389

Before, during and after theatre 392

13 Legal and ethical practice 397

The doctor-patient relationship 397

Appropriate resuscitation and DNAR 399

Death certification 400

Capacity, consent and competence 404

Child protection 407

Mental health act 409

Driving 411

Notifiable diseases 414

HIV testing 414

Computers and data protection 416

14 Looking after yourself 418

Occupational health department and personal health 418

Aggression and violence 420

Difficult colleagues and colleagues in difficulty 422

Complaints handling 424

15 Developing a career 426

Choosing a career 426

Applications, CV and interviews 428

Appraisal and assessment 430

Research 432

Teaching and life-long learning 433

Making and giving presentations 435

16 Working as part of the system of care 439

The good doctor 439

Clinical governance 440

Patient safety and risk management 440

Healthcare-associated infection 441

Audit 443

Evidence-based medicine, statistics and guidelines 445

Diversity, religion, culture and disability 448

Primary and secondary care interface 451

Epidemiology, screening and health promotion 452

Rehabilitation 455

Complementary and alternative therapy 456

17 Working in the UK 458

The new post 458

Finance 460

Leave 461

Important professional bodies 463

Index 466