The Hands-on Guide for Junior Doctors -- Contents -- Introduction -- How to use this book -- Acknowledgements -- Dedication -- Abbreviations -- 1 Starting up -- Panic? -- People to help you -- Three basic tips -- Other useful start-up information -- Dress -- Equipment -- First-day paperwork -- Geography -- Ward rounds -- Social rounds -- Night rounds -- Discharging patients -- Work environment -- Bibliography -- 2 Getting organized or 'The Folder' -- Personal folder and the lists -- How to make a personal folder -- Keeping track of patients (List 1) -- List of things to do (List 2) -- Results sheet (List 3) -- Data protection and confidentiality -- 3 Paperwork and electronic medical records -- Patient notes -- Accident forms -- Blood forms and requesting bloods -- Consent -- Death and cremation certificates -- Discharge summaries (TTO/TTA) -- Drug charts -- Drug prescriptions -- Handovers -- Referral letters -- Self-discharge -- Sick notes -- 4 Accident and emergency -- General -- Admitting and allocating patients -- Keeping track of patients -- Medicine -- Overdose -- In general -- Treating the patient -- Surgery -- Medical and surgical assessment units (MAUs and SAUs) -- Fast-track patients -- 5 Becoming a better doctor -- Foundation programmes (for UK readers) -- Assessments -- Moving on from the Foundation programme -- Information technology -- The internet -- Online medical databases -- Keeping up with the literature -- Evidence-based medicine -- Clinical governance and paraclinical work -- Clinical audit -- Case reports -- Courses -- Professionalism -- Communication -- Consultants and senior registrars -- GPs -- Nurses -- Patients -- Patients' families -- Confidentiality -- Exceptions to keeping confidentiality -- Consent -- References -- 6 Cardiac arrests and crash calls -- Cardiac arrest calls -- 'Do not resuscitate' (DNR) orders.

7 Common calls -- How to use this section -- Considerations for all ward calls -- Abdominal pain -- Differential diagnoses -- Anaemia -- Arrhythmia -- Calcium -- Hypercalcaemia -- Hypocalcaemia -- Chest pain -- Differential diagnoses -- Confusion -- Differential diagnoses -- Constipation -- Differential diagnoses -- Diarrhoea -- Differential diagnoses -- Electrocardiograms -- Important ECG abnormalities to recognize -- Eye complaints -- The acute red eye -- Sudden loss of vision in one or both eyes -- Floaters -- Falls -- Differential diagnoses -- Fever -- Differential diagnosis -- The immunocompromised patient with fever -- Fits -- Differential diagnoses -- Intravenous fluids -- Upper gastrointestinal bleeds -- Lower gastrointestinal bleeds -- Glucose -- Haematuria -- Headaches -- Differential diagnoses and key symptoms -- Hypertension -- Peri-operative hypertension -- Hypotension -- Differential diagnoses -- Insomnia -- Differential diagnoses and suggested management -- Management with benzodiazepines -- Itching -- Differential diagnoses (if no visible skin lesions or rash) -- Major trauma -- Minor trauma -- The moribund patient -- Nausea and vomiting -- Differential diagnoses -- Oxygen therapy -- Methods of oxygen delivery -- Pulse oximetry -- Phlebitis -- Management -- Potassium -- Hyperkalaemia -- Hypokalaemia -- Rashes and skin lesions -- Disease categories 1-10 -- Shortness of breath -- Differential diagnoses -- Diagnosing the important common conditions causing acute SOB -- The sick patient -- Sodium -- Hyponatraemia -- Differential diagnoses -- Transfusions -- Blood transfusions -- Platelet transfusions -- Urine, low output (oliguria/anuria) -- Basic emergency routine -- Obstetrics and gynaecology calls -- Talking to the patient -- Gynaecological examination -- Obstetric examination -- Being a male -- Common gynaecological calls.

Termination of pregnancy (TOP) -- 8 Death and dying -- Terminal care -- Communication -- Breaking bad news -- Ongoing communication with dying patients -- Pain control -- Symptom control -- Prescribing for the dying -- Support for the dying and for you -- Death -- What to do when a patient dies -- Telling relatives about the patient's death -- Religious practices on death -- Post mortems -- Death certificates -- Writing the death certificate -- Referring to the coroner (Scotland: procurator fiscal) -- Cremation forms and fees -- To check for pacemakers -- Further reading -- 9 Drugs -- General -- Prescribing drugs -- Drug charts -- Writing prescriptions -- Controlled drugs -- Verbals -- Giving drugs -- Drug infusions -- Intravenous drugs -- Specific drug topics -- Antibiotics -- Anticoagulation -- Anti-emetics -- Digoxin -- Night sedation -- Therapeutic drug levels -- Steroids -- Miscellaneous tips -- 10 Handle with care -- Alcoholism -- Alcohol withdrawal -- Children -- Depression -- Elderly patients -- Haemophiliacs -- Taking blood -- For theatre -- HIV/AIDS -- Taking blood -- HIV testing -- Jehovah's Witnesses/Christian Scientists -- Pregnant women -- Sickle cell anaemia -- The patient on steroids -- Side effects of steroids -- Managing ill patients on steroids -- Treating common side effects -- Withdrawing steroid therapy -- 11 Approach to the medical patient -- History and examination -- Clinical stalemate -- Preparing patients for medical procedures -- Cardiac catheterization -- Elective DC cardioversion -- Upper gastrointestinal endoscopy -- Colonoscopy -- Flexible sigmoidoscopy -- Liver biopsy -- Pacemaker insertion -- Renal biopsy -- Specialist referrals and investigating the medical case -- Cardiology -- Gastroenterology -- Haematology -- Neurology -- Renal medicine -- Respiratory medicine -- Rheumatology -- 12 Pain -- Pain control.

General -- Specific analgesics -- Inhaled drugs -- Oral drugs -- IM/IV opiates -- Other -- Pain control by severity and underlying condition -- 13 Practical procedures -- General hints -- Arterial blood gases -- Interpreting arterial blood gases -- Respiratory disease and arterial blood gases interpretation -- Bladder catheterization -- Men -- Women -- Blood cultures -- Venepuncture -- Cannulation (Venflon/Line insertion) -- Central lines -- Insertion of central lines -- Problems with temporaryand tunnelled central lines -- Using central lines -- Measuring the CVP -- Chest drains -- Managing a chest drain -- How to remove a drain -- DC cardioversion -- Electrocardiogram -- Reading ECGs -- Exercise stress test -- Relative contraindications (discuss with senior) -- The procedure -- Glucose tolerance test -- Injections -- Subcutaneous -- Intramuscular -- Intercostal block -- Joint aspiration/injection -- Aspiration -- Injecting joints -- Local anaesthesia (for any procedure) -- Lumbar puncture -- Mantoux test -- Nasogastric tubes -- Peritoneal tap (paracentesis) -- Pleural aspiration -- Pulsus paradoxus -- Respiratory function tests -- Spirometry -- Peak expiratory flow rate -- Sutures -- 14 Radiology -- Requesting investigations -- Minimizing radiation -- Common concerns about X-rays -- Pregnancy -- Plain films -- Chest X-rays before surgery -- Skull X-rays -- Abdominal films -- Contrast studies -- Intravenous urography -- Barium swallow -- Barium meal -- Small bowel enema -- Barium enema -- Ultrasound -- Computed tomography -- General -- CT head - some emergency indications -- Arteriography -- Magnetic resonance imaging -- Radioisotope scanning -- 15 Surgery -- Clerking: pre-admission clinic -- Perioperative prescribing -- Consent -- Common or important expected side effects after specific surgical procedures -- Anaesthetics.

Drawing up theatre lists -- Marking patients for surgery -- Post-operative care -- Complicated patients -- Jaundice -- Diabetes -- Steroid-dependent patients -- Thyroid surgery -- Pituitary surgery -- Day surgery -- Oro-facio-maxillary surgery -- Surgical protocol clerking sheet -- 16 General practice -- What you can and cannot do -- You can: -- You cannot: -- Referral letters and note keeping -- General points -- Public health and health promotion -- The hidden agenda and health beliefs -- Follow-up -- Home visits -- 17 Self-care -- Accommodation -- Alternative careers -- Bleep -- British Medical Association (BMA) -- Car and insurance -- Clothes (laundry/stains) -- Contacting medical colleagues -- Contract and conditions of service -- What you need toknow about your contract -- Doctors' mess -- Making money for the mess -- Drug representatives -- European Working Time Directive -- Insurance (room contents) -- Jobs -- Trust and other non-training posts -- Curriculum vitae -- The interview -- Consultant career prospects -- Locums -- Meals -- Medical defence -- Money -- Income protection if long-term sick or disabled -- Student debt -- Mortgages -- Payslip deductions -- Pensions -- Tax -- Telephone and online banking -- Needlestick injuries -- If the patient is known to be HIV-positive -- If the patient is known to be hepatitis-positive -- Not coping -- Part-time work (flexible training) -- Representation of junior doctors -- Sleep and on-call rooms -- When things go wrong -- Bullying and psychological stress -- Whistle-blowing -- Appendices: Useful tests, numbers and other information -- Addresses -- Barthel score -- Glasgow Coma Scale (GCS) -- Mental Health Act -- Mini-mental test score -- Notifiable diseases -- Results -- Haematology -- Biochemistry -- Useful biochemical formulae -- Fitness to drive -- Index -- Further resources.