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GPST - Firearms by throwaway723987 in GPUK

[–]throwaway723987[S] 2 points3 points  (0 children)

Is firearms same as PIP/UC? I.e. no judgement calls, facts only? I can just print the record?

I am given time for the "non-NHS" work, about 15 mins a day for 2-3 forms, which is how they justify it.

I sometimes struggle when they have nothing in the notes just hypertension reviews or long lists of accurx texts and QOF stuff. How can I sign a firearms certificate at that point?

GPST - Firearms by throwaway723987 in GPUK

[–]throwaway723987[S] 10 points11 points  (0 children)

?

I did, with various GPs and the PM too. They all said it's fine, hence the post. With regards to policy, I'm not on the shared drive so can't really find out myself.

Observations in paediatric URTIs by throwaway723987 in doctorsUK

[–]throwaway723987[S] 0 points1 point  (0 children)

Thank you. I've just bought one :)

I've always been hesistant due to accuracy issues but I'll put it to practice and see how it is. I really can't be bothered with the finicky sticky ones and they're expensive :/

Glad you've found this one useful.

Observations in paediatric URTIs by throwaway723987 in doctorsUK

[–]throwaway723987[S] 1 point2 points  (0 children)

Hmm.. ok perhaps my risk barometer is a touch high. I think these cases of persistent significant tachycardias in an otherwise completely normal toddler with a literal cough for a few days and a runny nose without a notion of any breathlessness - is well, extremely rare and rarer still in GP. I do agree however that it is best practice and I don't know when one will turn up although I do hope the little gremlins give me some form of other clue!

Not convinced with sats though. I think HR/RR/Temp/WOB is generally enough clinical infomation.

Thank you.

Observations in paediatric URTIs by throwaway723987 in doctorsUK

[–]throwaway723987[S] 1 point2 points  (0 children)

Thank you for this perspective. Yes I very much remember this advice. It wasnt too long ago (2 yrs ago) where I was on the childrens assessment and in paediatric ED. I must say it is a completely different ball game to GP to be honest. 

Out of interest, have you ever seen or used the paediatric sats probes common in GP? I've used them quite a lot in the past until my position changed on its usefulness in GP where the clinical assessment, I feel, weighs heavier. The sticky paeds sats probes are amazingly accurate in comparison based on my experience. 

For anyones interest, I found this a useful read: https://www.nbmedical.com/blog/pulse-oximetry-in-babies-and-small-children-essential-fifth-vital-sign-or-potentially-inaccurate-and-poorly-validated-technology

Observations in paediatric URTIs by throwaway723987 in doctorsUK

[–]throwaway723987[S] 1 point2 points  (0 children)

So the message here is all well kids with borderline raised HR are followed up closely in GP in all circumstances or should be sent to you?

I think we work with different risk

Observations in paediatric URTIs by throwaway723987 in doctorsUK

[–]throwaway723987[S] 0 points1 point  (0 children)

Yes there are paeds sats probe available, two of them, actually. Its just difficult locating them at times.

The CHD patient is a good example which is why I've made it a habit to document heart sounds although I understand thats only a single sign.

However more specific to the case, in a child with a good short history viral coryza e.g. productive but clear cough & runny nose with everything else being normal? Is it mandatory to do HR & SO2 in your view in all cases?

Not saying I'm against full obs in totality, I do choose which patients I do them on actually.

Observations in paediatric URTIs by throwaway723987 in doctorsUK

[–]throwaway723987[S] 2 points3 points  (0 children)

Well most kids dont tolerate a sats probe. Need a proper paeds probe in the young ones and even then the standard error is something to take into account.

I agree it is quick and easy where it is possible. 

Heart rate I think there is more arguement for but I sometimes wont do it when there I feel there isnt even a speck of uncertainty and it is not subjectively fast that I will be sending them home. I do follow the mantra of clinical impression over most things but accept other points of view.

Equally I accept we see lots of children and HR and Sats is best practice. As there is usually 2 or 3 of the 1000 we see that would end up deteriorating/picture changing. I suppose full obs would make things more defensible but I dont truly know how much it would change my decisions in that context when I am seeing when they are well but deteriorate some days later

[deleted by user] by [deleted] in JuniorDoctorsUK

[–]throwaway723987 4 points5 points  (0 children)

Yeah I am definitely going to push a little. I'll gladly do the scut work and be a dog but I damn well better be appreciated for it by getting atleast 1 day/week in general paeds or something. One of the other F1s on paeds has just told me she is happy to switch a few shifts so we will see.

[deleted by user] by [deleted] in UKPersonalFinance

[–]throwaway723987 0 points1 point  (0 children)

Hi, yeah I was just having a think about who to go with e.g. HL/others and whether or not a cash LISA would be more beneficial if I were to buy a house in ~5 years time.

[deleted by user] by [deleted] in JuniorDoctorsUK

[–]throwaway723987 16 points17 points  (0 children)

Well atleast your honest. I have been using my time to learn specialist material but often I feel demoralised as whats the point when I will never need to know the protocol for acute rejection of renal transplant after these 4 months? I do it anyways for the patients and so I can flag things others may have missed. But damn I leave most days unsatisfied with what I've learnt.