By J. R. Playfer (auth.), M. Lye (eds.)
Most sufferers in built international locations with clinical difficulties requiring sanatorium care are aged. more and more the dividing line among normal inner medi cine and acute geriatric medication is turning into extra blurred. it truly is, however, obvious that a few aged sufferers on clinical or sub-specialty medical institution wards develop into 'bed blockers'. Why? additionally, why are 'bed blockers' much less of an issue on an acute geriatric ward? Many clinicians think this is often relating to a swifter entry to the long-stay beds of the geriatric unit. Even a quick examine of sanatorium working records will convey this isn't and can't be the case. whilst geria tricians are requested to determine aged 'bed blockers' on colleagues' wards they process with anxiousness simply because those sufferers frequently need to be put on an extended ready checklist for those scarce and extremely dear carrying on with care beds. Do geria tricians see diverse acute clinical difficulties in comparison with their colleagues? the answer's now not instantly visible, even though geriatricians are inclined to obtain extra strength 'bed blockers' than their common scientific colleagues. How is it then, that geriatricians appear to cope larger than their colleagues? All geriatricians have event of normal inner drugs however the contrary regrettably doesn't carry. This booklet is written within the desire of redressing the imbalance.
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Table 7 Investigation of a stroke patient In all cases To be considered in selected cases Haemoglobin Haematocrit White count Erythrocyte sedimentation rate Blood glucose Urea and electrolytes Serum tests for syphilis Electrocardiogram Urine examination Chest X-ray Skull X-ray Neurological Isotope brain scan CT Scan EEG Lumbar puncture Cardiological Endocardiogram 24ECG Cardiac catheterisation Haematological Clotting studies Protein electrophoresis Other Blood cultures Temporal artery biopsy ANA, DNA binding Cervical spine X-ray Serum lipids, etc.
Myocardial infarct Non-stroke causes of coma (Table 4) Table 4 Causes of coma Head injury Metabolic (hypoglycaemia; hyperglycaemia; hepatic failure; uraemia; hypercalcaemia; myxoedema) Toxic (drugs, alcohol) Hypertensive encephalopathy Hypotension Respiratory failure Bacteraemic shock Notwithstanding these rather daunting lists of differential diagnoses, the clinical diagnosis of stroke will usually be accurate provided that a careful history is taken, a full examination performed and a few simple investigations carried out.
Thiazide and potassium-sparing diuretics in the elderly. British Journal of Clinical and Experimental Gerontology,S, 43-55 Dickstein, K. and Gundersen, T. (1983). Successful management of severe congestive cardiac failure with enalapril. American Journal of Medicine, 75, 721-3 Dobbs, S. , Mawer, G. , Rodgers, E. M. and Woodcock, B. G. (1976). Can digoxin dose requirements be predicted? , Nicholls, M. , Ikram, H. and Espiner, E. A. (1983). Hemodynamic, hormonal and electrolyte effects of enalapril in heart failure.
Acute Geriatric Medicine by J. R. Playfer (auth.), M. Lye (eds.)