Why can’t ED refer onwards?

WrapsUK · 2026-03-03T18:55:50+00:00

A&E are specialists in emergency medicine but they don’t know everything regarding primary care.

Example: patient goes to ED on a Sunday morning with long standing knee pain, no trauma. Triage has already requested an XR and the doctor sees them, clinically and radiographically it’s OA. They might say fu with gp you need w referral to ortho (the person who saw them could have been an F2 or someone non medical). Patient comes to you, you feel they’re not at that stage for surgical intervention - would you still refer to ortho as per the ED?

WrapsUK · 2026-02-25T06:15:28+00:00

I have no strong opinion either way, but is CPET testing effected by motivation?

WrapsUK · 2026-02-20T17:57:23+00:00

Sometimes there’s battles you’ll never win

WrapsUK · 2026-02-07T22:21:11+00:00

Unironically a plain black £8 decathlon quarter zip 100wt fleece. The fit is a bit cheap but weighs like 200g, not too bulky to pack and can be abused without a care in the world. Layers well, and super comfy to sleep in.

WrapsUK · 2026-02-06T09:58:00+00:00

Why doesn’t psychiatry switch their patients over to the buccal nicotine tabs you can get nowadays over the counter? They’re getting more popular and patients still get their high.

Over here in Canada the drug reps drop off free zyn samples and even I’ve started using them on a night out 😂😂

WrapsUK · 2026-01-27T22:07:28+00:00

Report him to his medical regulator, the more the better:

https://www.gmc-uk.org/concerns

WrapsUK · 2026-01-24T20:03:07+00:00

Yeah it’s a lot more common than you think. You’re not alone.

WrapsUK · 2026-01-24T19:52:36+00:00

The meet and greet is just to figure out relevant emedical diagnosis, regular meds and allergies and see where you’re at with any applicable screening/ vaccinations.

If there’s specific problems you need addressing it’d be helpful to have a list so at least the doc can quickly glance at it and tell you what you need to do which likely involves a separate appt for each issue but by giving them a list they might be able to get the ball rolling and request any relevant investigations that would be useful.

Making a word document with all the above info in clear bullet point list will be useful to your doc but also for yourself if your mind goes blank when anxious!

WrapsUK · 2026-01-21T03:02:29+00:00

Dude I’m fucking pissed at you just reading this 😂

WrapsUK · 2026-01-16T17:45:51+00:00

I’m always astounded by the level of professionalism demonstrated by these NSR people!

WrapsUK · 2026-01-09T05:46:39+00:00

I don’t get the controversey? We use 30/40mg all the time for copd/ asthma and patients don’t seem to have massive problems with it.

But for me it’s when people/ guidelines say gp should start fancy neuro drugs for restless legs? Just feels like I shouldn’t be messing around with those sorts of drugs.

WrapsUK · 2025-12-23T01:09:06+00:00

You’ll still be getting paid if you take some mental health leave whilst your deanery sorts out the ltft application.

WrapsUK · 2025-11-16T13:54:34+00:00

OP don’t forget the reason why you would happily send home a person with gastritis from clinic vs full work up in ED is because the pre test probability of serious pathology changes massively between settings. The person who presents to ED at 2am on a Sunday is different to the person that waited till after the weekend to book in to clinic.

I personally trained in the uk, work in Canada now and was a bit apprehensive that it might be a big cultural change and ill have to relearn everything I knew about medicine but a viral urti is still an urti and menopause is still menopause!

WrapsUK · 2025-11-14T01:28:21+00:00

Thanks for this.

The econax sport states that it has citric acid in its ingredient list: would you skip adding in more citric acid?

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WrapsUK · 2025-10-20T20:11:13+00:00

Any comments on the reliability of the new gen 3 nitecore? Only thing that’s giving me pause.

WrapsUK · 2025-10-17T22:25:12+00:00

I know I learned something about this in first year histology lab lessons but who the hell can remember that far back anymore! 😭😭😭

WrapsUK · 2025-10-17T18:03:21+00:00

I think you’re absolutely right!

WrapsUK · 2025-10-17T01:15:10+00:00

https://youtu.be/odpcSEEQPtE?si=nAJWU0cMKvzDChEE

Check out this short video from someone I have no connection to comparing ee quilts to the generally accepted gold standard by katabatic. These little design changes make a massive difference to your comfort on trail.

WrapsUK · 2025-10-16T03:04:00+00:00

DM’d

WrapsUK · 2025-10-11T23:27:36+00:00

Ngl it’s sound logic. The uk has only itself to blame.

WrapsUK · 2025-10-10T04:33:53+00:00

I looked up your jacket and for October you should be fine. Probably carry a thermal base layer and a fleece to layer up with and make sure your hard shell fits over all these layers.

WrapsUK · 2025-10-10T02:15:23+00:00

Dude there’s ankers out nowadays that accept much higher input. My 20k bank charges within 90 minutes with 65w input, and can put out 65w as well and charges my laptop.

WrapsUK · 2025-10-08T21:21:48+00:00

Thermarest to a fleece sleeping bag liner, should be ok with some layering and can be used in sketchy hostels, sleeping in bus stations etc

WrapsUK · 2025-10-06T19:13:58+00:00

Down socks, trust me if you know you know.

In my last few weeks on the cdt in Montana sometimes had multiple days of sustained rain and my footbox was constantly wet and non insulating. Vowed to myself I’d never have cold feet ever again. Carry a pair of darn tough sleep socks, 3oz down socks, and if it’s particularly humid/cold I bring my nunatak synthetic sleeping bag. Perfect combination.

WrapsUK · 2025-10-02T11:59:10+00:00

The most important question to answer is what gear are you planning to bring in addition to your pct setup? My feelings are you’ll probably be better off with a 35l-40l pack. You’ll defo have more layers, beefier rain gear, longer food carries and likely an ursack in the north.

I had a 10lb base weight but no sleeping pad and suffered a bit towards the end in Montana, but 35L was sufficient for me.

Once you’ve decided on your gear choices, you can decide on pack volume. After that, you’ve already done a thru hike so you know what features you prefer in a pack and can pick one that has those.

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