This is exactly the way how we talk with our colleagues. This was so new to me before I started working in UK. Everyone is too polite but firm at the same time.
I chose to watch this to gain confidence in being a first aider. I hoped to hear some reassurance to Micheal. He was conscious and could hear and understand what was being said. What rung in my ears, when the doctor spoke to the nurse was, ‘ l’m most concerned!’ I think if l heard urgent and most concerned and being told how hot l was, several times, l think l’d have breathing problems. The rest was brilliant!
This isn't first aid, we are all here because we hold MBChB (bachelor of medicine and surgery) degrees, and me personally I hold MRCEM Member of the Royal College of Emergency Medicine, so my speciality is emergency medicine.. You never lie to a patient. What do you think happens in our emergency department when someone comes in quite sick but alert say after an RTC, do you think we whisper as doctors about the condition of our patients? No, unfortunately my/our main priority is stabilising my/our patient and that means discussing with other members of the medical/trauma team Infront of the patient for example during a primary or secondary survey before going to scan, or theatre we shout as team leaders each part of our survey and ask for a response from each individual doctor and nurse on the trauma team who are working in different roles. Oh and finally we do reassure our patients😊!
this was excellent - I can struggle staying on track with A-E during my simulation training but this will help me present my findings in a smooth way whilst still focusing on the patient.
Brilliant video many thanks - the Dr should have specified which broad spectrum IVABX he wanted from the Nurse - check allergy status/drugs chart first.
@@nadinehowarth1420 Any medications given have to have been signed for on a prescription by the doctor before being given so any allegies would come up the and also allergy patients wear a large bright red wrist band with their allergies so this wouldn't happen.
this was great, I was sent it as part of my nurse training. I particularly found the nurse's helpful modelling of the SBAR model for communicating with the on-call Registrar. The literature suggests this helps the two professionals share a 'common clinical understanding' of Michael's worsening condition. I was surprised when the Reg asked the Nurse to attach a pulse oximeter - I would have assumed one was attached while doing the ABCDE assessment. Did the Nurse interrupt the ABCDE assessment after B in order to address the fast breathing rate?
It’s for demonstration and the exam. You have to ask for the obvious even though it would (hopefully) be done. Like doing a driving test you have to over exaggerate looking in your mirrors or say it so the instructor knows you are doing it
Read the comments here highlight the mouse and cat relation between nurses and doctors. Some comments suggested that we do much than the other people missing out on the interprofessional aspect of working with each other. Overrall i think this video is brilliant and was more of a real situation scenario than text book knowledge.
visit DR.ADULE today on his TH-cam channel for any type of virus or disease or infections he Is a great traditional doctor.infection like herpes fibroids hpv als.etc
Did you watch the beginning o the video? Post obs was what the Dr was asking as they collaborate. There were a few things he could do before though. oxygenating the Pt and putting in a cannula.
Does the doctor think nurses are silly ? We are much smarter and more empowered, we would already be doing all of these. But if the nurses didn’t know what they were doing fair enough it’s nice that he would keep calm and explain things to him.
@@jadebaxter8203 It's not that we are trained to think nurses are silly, it's just that in an exam scenario we have to explain out loud what we want done and why, so the examiner knows that we are aware of the steps. In the real world as you say, by the time you turn up the nurses have usually already put on monitoring, put cardiac leads on, done a glucose etc... but this is just exam world, that's all!
laa2009 Yes I understand, I just wish I saw more of what we actually can do online. We are drip fed this, but we do often have a lot of training we could decide shockable and non shockable rhythms and H’s and Ts, it would be nice to just see that a little. I’m just a student anyway I don’t really know much ! Thank you for your reply!
@@hunterz2006 I can see your point but why can't they monitor it without a catheter as a catheter is invasive and can cause infection by itself. Would it not be possible to wee into a bottle and measure the quantity of urine that way?
Tom Grant hey man. 🙂the output then has to be monitored continuously and closely for careful fluid balance. Unfortunately can’t rely on voiding ability which may be affected by many things.
That nurse was too calm for me. Also, don't you try to do some interventions before escalating? Like do ECG since the patient is tachy, have IV access and also give paracetamol for the spike.
Ecg needs to be ordered by the doctor according to patient complain and news score, again doctors prescrives iv and you do cannulation. Paracetamol prescribed ot on prn than nurse can give however he is scoring high on news he has sepsis detorating fast needs doctor
Doctor requested him to be on heart monitor so equivalent of live ECG, he’s asked for IV access, fluids and is going to give the IV antibiotics at the same time as the nurse is setting up the fluid bag.
I wonder nurse doing bloods wow in ireland no way . No matter how sick patient is sick , 2 doctors looking after 200 patients over night and no nurse will dare to put cannula or bloods even if news is 11 ... so lucky doctor
Generally it was a good approach but it appears strange if you watch this video nowadays with no any PPE used prior to assessing the patient. May need updating..
@@laa2009 Yes. He needs an holistic plan, including vitals every 15 -30 minutes. I said that because an assessment during a fever can yield a different result that an assessment in the absence of fever. Most patients in pain don't talk to you or give you a proper history. Thus we give some pain reliever in an attempt to get a proper history to manage correctly. Thanks.
So all the Senior Doctor did at the end of the day was examine him, prescribe him IV Antibiotics and fluids ! So much unnecessary drama for something so basic. They’re like puppets in the UK. Bending over to stick to guidelines and protocols. Zero creativity. Any sensible Dr in any part of the world would’ve done the same thing without necessarily sticking to this shit abcde assessment. Dumb
OMG he does not need an ITU review, some Ivabx and paracetamol will bring his temp down, which will help bring resps and pulse down, as his body will then be able to meet the Oxygen demand. The iv fluids will help support BP and should contain any systemic inflammatory response, ie the septic responce.
This is exactly the way how we talk with our colleagues. This was so new to me before I started working in UK. Everyone is too polite but firm at the same time.
Heyeyeye...
E3y3u3u3uu3u3u
Eyeeye and
My goodness I was so into this video, i'm disappointed it ended before I knew how Michael is doing. hahah
toward the end, they say it- its sepsis.
I mean how he turned out. If he recovered well haha
I was the exact same Jordan
@@Smubbs he definitely lived. I knew Michael and can confirm he has a job in Tesco now.
I think they use actors for demonstrations....
As a 2nd year student nurse I found this video really helpful and very interesting.
These are the best educational videos. The patient actors do such a great job and look and act like real patients
This was really helpful to me for my clinical exam in February. I like the team work here. The doctor is also very confident
amazing and a confidence Doctor and the entire team involved. very useful video for students like myself.
I chose to watch this to gain confidence in being a first aider.
I hoped to hear some reassurance to Micheal. He was conscious and could hear and understand what was being said.
What rung in my ears, when the doctor spoke to the nurse was, ‘ l’m most concerned!’
I think if l heard urgent and most concerned and being told how hot l was, several times, l think l’d have breathing problems.
The rest was brilliant!
This isn't first aid, we are all here because we hold MBChB (bachelor of medicine and surgery) degrees, and me personally I hold MRCEM Member of the Royal College of Emergency Medicine, so my speciality is emergency medicine.. You never lie to a patient. What do you think happens in our emergency department when someone comes in quite sick but alert say after an RTC, do you think we whisper as doctors about the condition of our patients? No, unfortunately my/our main priority is stabilising my/our patient and that means discussing with other members of the medical/trauma team Infront of the patient for example during a primary or secondary survey before going to scan, or theatre we shout as team leaders each part of our survey and ask for a response from each individual doctor and nurse on the trauma team who are working in different roles. Oh and finally we do reassure our patients😊!
This video is really useful for every medical student out there. Thank you so much for making it. ❤️
this was excellent - I can struggle staying on track with A-E during my simulation training but this will help me present my findings in a smooth way whilst still focusing on the patient.
Brilliant. Very clear demonstration on the right way to do it!
Brilliant video many thanks - the Dr should have specified which broad spectrum IVABX he wanted from the Nurse - check allergy status/drugs chart first.
They always give Co-Amoxiclav before a blood test, so the doctor is right.
@@sloane290 allergy status should have been done before anything is given. Each hospital has its own policy, some us IV Tazocin instead of co-amox
@@sloane290 and you would have just killed me as I am allergic to penicillin.
@@nadinehowarth1420 Any medications given have to have been signed for on a prescription by the doctor before being given so any allegies would come up the and also allergy patients wear a large bright red wrist band with their allergies so this wouldn't happen.
@@sloane290 bloods should be taken before IVABX unless there is the presence of purpura fulminans
this was great, I was sent it as part of my nurse training. I particularly found the nurse's helpful modelling of the SBAR model for communicating with the on-call Registrar. The literature suggests this helps the two professionals share a 'common clinical understanding' of Michael's worsening condition.
I was surprised when the Reg asked the Nurse to attach a pulse oximeter - I would have assumed one was attached while doing the ABCDE assessment. Did the Nurse interrupt the ABCDE assessment after B in order to address the fast breathing rate?
It’s for demonstration and the exam. You have to ask for the obvious even though it would (hopefully) be done. Like doing a driving test you have to over exaggerate looking in your mirrors or say it so the instructor knows you are doing it
Eyeeyeyeyeeyyeyeeeyeeyeyeyeyeyyeyeyeeyye and
Read the comments here highlight the mouse and cat relation between nurses and doctors. Some comments suggested that we do much than the other people missing out on the interprofessional aspect of working with each other. Overrall i think this video is brilliant and was more of a real situation scenario than text book knowledge.
Wow!
I like the systematic approach of the assessment. Nothing was missed...
NHS are very friendly (staff),we are grateful thank you
Very informative, professional team-mates and helpful for my forthcoming Clinical OSCA. Bravo!
Thank you, RC and all members of this great work :)
Such a good video. Brilliant.
Thank you for making these video's.
l am in my second year and find this video very informative and educative. It kind of reassured me and boost my confidence.
very informative ! great for learning purposes and will be incorporating this into my assessment piece :)
This is amazing !! Thank you so much !!!
Who's here from BSMS Virtual Work Experience Course?
visit DR.ADULE today on his TH-cam channel for any type of virus or disease or infections he Is a great traditional doctor.infection like herpes fibroids hpv als.etc
Me too, but what we can do is just...imagine it
How's Michael? Did he make it?
Brilliant job great assessment
I found this video very useful
How did you get a NEWS score of 9 if you didn’t connect the monitorng equipments
WHAT ANTIBIOTICS DOCTOR DONT DO ME LIKE THAT
This is okay but nurses usually would have done so much already before patient got to this stage.
The most important, THANK YOU !
As a nurse, I have monitoring the patient asap while the doctor was coming....
Did you watch the beginning o the video? Post obs was what the Dr was asking as they collaborate. There were a few things he could do before though. oxygenating the Pt and putting in a cannula.
Does the doctor think nurses are silly ? We are much smarter and more empowered, we would already be doing all of these. But if the nurses didn’t know what they were doing fair enough it’s nice that he would keep calm and explain things to him.
@@jadebaxter8203 It's not that we are trained to think nurses are silly, it's just that in an exam scenario we have to explain out loud what we want done and why, so the examiner knows that we are aware of the steps. In the real world as you say, by the time you turn up the nurses have usually already put on monitoring, put cardiac leads on, done a glucose etc... but this is just exam world, that's all!
laa2009 Yes I understand, I just wish I saw more of what we actually can do online. We are drip fed this, but we do often have a lot of training we could decide shockable and non shockable rhythms and H’s and Ts, it would be nice to just see that a little. I’m just a student anyway I don’t really know much ! Thank you for your reply!
@@jadebaxter8203 probably not the best examples to give when trying to argue you have a wide scope of practicee
I startet to learn the abcde sines last week.
Why is a urinary catheter advised since the staff nurse said the patient was self voiding and they didn't mention any urinary retention?
Monitor urine output/ AKI
@@hunterz2006 I can see your point but why can't they monitor it without a catheter as a catheter is invasive and can cause infection by itself. Would it not be possible to wee into a bottle and measure the quantity of urine that way?
It’s part of Sepsis 6
@@user-xy4ff5yp7b It isn't. Monitoring urine output is, doesnt require a catheter
Tom Grant hey man. 🙂the output then has to be monitored continuously and closely for careful fluid balance. Unfortunately can’t rely on voiding ability which may be affected by many things.
Wow. Great video
Excellent
If only the doctors that some people who really need them are like this...
Really nice video
That nurse was too calm for me. Also, don't you try to do some interventions before escalating? Like do ECG since the patient is tachy, have IV access and also give paracetamol for the spike.
Ecg needs to be ordered by the doctor according to patient complain and news score, again doctors prescrives iv and you do cannulation. Paracetamol prescribed ot on prn than nurse can give however he is scoring high on news he has sepsis detorating fast needs doctor
Doctor requested him to be on heart monitor so equivalent of live ECG, he’s asked for IV access, fluids and is going to give the IV antibiotics at the same time as the nurse is setting up the fluid bag.
Acute abdomen. Most likely perforated viscus with sepsis with probably in shock. May be having acute kidney injury as well.
Abdo was SNT so unlikely to have perf, the loin pain raises suspicion of pyelo so looks more like urosepsis than an acute abdomen.
What a fucking legend
Awsome video.. apart from the auscultation bit .. I think he auscultated the trapezius 🤔.. but overall the scenario was perfectly played.. brilliant
That was auscultation of the apices
Thanks
👍👍👍👍👍👌👌👌👌👌
Is wearing gloves not a routinely done practice as I observed the examining physician is without them?
Gloves are not required for examination in normal circumstances. Currently the guidance is 2r mask, eye protection, appron or full cover and gloves.
Regular hand hygiene should be top priority but gloves are only required when at risk of exposure to blood or bodily fluids.
I wonder nurse doing bloods wow in ireland no way . No matter how sick patient is sick , 2 doctors looking after 200 patients over night and no nurse will dare to put cannula or bloods even if news is 11 ... so lucky doctor
Who’s here from bsms
meeeee
@@irfanusman227 yep me too
any one have any idea what does the doctor say at 4:42-4.45?? i really dont understand.
Is this copyrighted? I’d like to use (with reference) as part of an educational study guide for medical students. Many thanks!
If your using it for educational purposes and not making money on it, it doesn't matter if it's copyrighted.
Hi Lucy, Can you email us at publicaffairs@resus.org.uk with details of the study guide and we will be in touch! Best, Emily
Where is thiis hospital?
Generally it was a good approach but it appears strange if you watch this video nowadays with no any PPE used prior to assessing the patient. May need updating..
QED 100%
Did we ever find out his BP?
99/59.. on the monitor:)
Within the realm of system errors, the transaction found its way to an invalid email address.
hi
Can we give antipyretics before continuing? Then reassess
Think this chap needs a bit more of a plan than "Paracetamol PRN and reassess"
@@laa2009 Yes. He needs an holistic plan, including vitals every 15 -30 minutes. I said that because an assessment during a fever can yield a different result that an assessment in the absence of fever. Most patients in pain don't talk to you or give you a proper history. Thus we give some pain reliever in an attempt to get a proper history to manage correctly. Thanks.
@@ayannageorge5258 Tell me you’re joking
@@zed3063 No.
@@laa2009 Not PRN but STAT
When you make video of someone who have hand pain
He’s got an illness like tick fever.
BSMS anyone?
bullshit , never reflective of the daily work
So all the Senior Doctor did at the end of the day was examine him, prescribe him IV Antibiotics and fluids ! So much unnecessary drama for something so basic. They’re like puppets in the UK. Bending over to stick to guidelines and protocols. Zero creativity. Any sensible Dr in any part of the world would’ve done the same thing without necessarily sticking to this shit abcde assessment. Dumb
It’s a basic video, not real life duh…
OMG he does not need an ITU review, some Ivabx and paracetamol will bring his temp down, which will help bring resps and pulse down, as his body will then be able to meet the Oxygen demand. The iv fluids will help support BP and should contain any systemic inflammatory response, ie the septic responce.
lol yeah ITU team must have been sat around, bored that day
He scored 9 on MEWS which necessitates review by ITU outreach team. It doesn't mean automatic admission to ITU.
Shouldn't he be put on IV fluids already that's what I had when I was like him
@@maisieswindells9113 Yes Maisie, within the hour of identifying sepsis
No back exam, No DVT ruled out = No wonder I failed the exam after using this video -))
he did the back exam
he check the legs for swelling and rashes - no erythema so wouldnt indicated dvt and lungs were clear
You obviously weren't watching.
he looks really sick😃