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My name is Vasiliki. I am an F one currently at King's. Um, I am doing orthopedics at the moment, um, as irritation and I'll be switching to I see you in two weeks. Um, I went to Imperial. I recognize some of the names in the chat, and and that's it. Um oh, I thought I had put my email. I'll just write it in the chat. I'll say it at the end as well. But feel free to contact me with questions about the slides about F one about final year. About whatever you need. Um, I'll, uh, I put my email at the in in the chat for you guys to use if you need, um, so we're gonna very briefly go through what is the acute care station? Uh, we're gonna just do some very, very common stations. This is not, um, necessarily, like a high yield, sort of niche type of, um, session. It will be very much the basics. Like things that you're really expected to know. Um, And what? We're gonna focus on these sort of how to approach the station using those those sort of common conditions. Um, I'm gonna go very briefly through some general tips for the station. Uh, and, um, I think there's a buck form somewhere. I haven't used this platform platform before. So, um, I'm gonna rely on hurry to sort of point people in the right direction for feedback. And, uh, so at the end of the presentation, I've included some slides. They're not actually complete. So make sure I just sort of add some stuff before sending them to hair if to distribute to everyone. But we're not going to go through the sort of the last bit. It's just gonna be like, just when you get the slides, there's gonna be like a bunch of stuff there for you to read in your own time, which is going to be a bit more detailed. Maybe a few more cases, um, or a few more conditions. Um, some housekeeping rules. This will be an interactive session. That's why I was really, um, persistent on whether you guys can turn on your your your your your camera. Sorry. Just your microphones. Um, and the more you interact, the faster it will go. I I'm I'm really patient. Um I can stay here for hours. I finished my shift. Um, I have a day off tomorrow. I can be here all night. Um, but this is basically for your benefit, right? So, um, there's very little point in me, um, talking through everything. Um, it's more for for you guys to get the chance to, um, talk through some of these, uh, through some of these slides. Um, we will aim for a tender break close to sort of, um, have, like, four cases. So maybe after two of them, you can take a small break. Um, but if, for example, you feel like No, you know what? I'm I'm good. We can keep going. This is not really tiring. Or after the first case, you're completely exhausted and you need a breather. Um, literally. Just like yourselves or right in the chat. Uh, and just say that you that you need a break and I'm more than happy to accommodate for people. Um, I think the third point, I I meant to change it because I feel like it sounds harsh, but in reality, like, there's no dumb question like this session is for for you, for for for everyone to sort of be on the same page about this station. Um, questions are always welcome. And there's no such thing as sort of dumb question or a silly question. Or like a like, a question that that shouldn't have, like, doesn't have a place in in in the session. Um, so honestly, feel free to on you at any point and ask whatever you guys want. Um, I need to put in this caliber that I am not any more affiliated with Imperial. And this is not not a content that's been approved by Imperial. It's content that, um, I've collected from sort of put other presentations on acute care station. And I've tried to attribute that, um, where where possible? Um, and from sort of my own clinical practice. Um uh, and actually, my experience on that occasion, um, trying to pull up together and show you guys what, like an acute care station would likely look like for you any Oh, yeah, right. I forgot I had that I thought were going straight to the cases. So the station, the acute care station, um, will invite students to do basically four main things. So you're you're gonna walk into your station and you're most likely going to be handed a piece of paper that has, um, some sort of history. Um, plus an examination, some sort of the commission of a patient's sort of presentation and whatever information has been gathered for that presentation, um, you will be asked to read that, um, you're beginning something like a minute or something. Um, depending on the Examiner, they might say, take over long as much as you need, or they're gonna sort of stop you. At some point, they will take that piece of paper back, which is really important. Also for the session, they will take that piece of paper back, and then we'll ask you to summarize the key findings from the history and examination. Um, they're gonna then ask you to suggest some differentials. So what could this be, um, for, I think, where the cases that I've put it's they're fairly straightforward. That the point also for the actual station is not for you to to start listing endless, um, conditions that this presentation might be, um, hinting towards, um, we're going to go through, like, a way that you can obviously you can have your own way, but there's gonna do suggested, uh, where you can split those differentials and can talk through them. Um, you're gonna be asked what sort of investigations you would like to order for this patient. And based on those, um, you'll be given, um, the investigations that you're asked for. You're gonna be asked to interpret them, um, and to act on them and sort of how and sort of basically then how you would eventually manage the patient. The last thing you'll be asked to do is some some sort of like next of kidnapped great update or patient update where you have to sort of summarize, um, what your diagnosis is, what the management is, um, and sort of show that you can communicate with a sort of non medical person and describe that condition. Um, the point of the whole station is to see if you are a safe doctor. But more specifically, if you're going to be a safe if one doctor and it's, I think it's really important to remember. Even though it's a nonpartisan, even though it's with an asterisk, it's really important to remember that your old next year will be an F one, doctor. Um And that's the benchmark that you're being, um, assessed against. No one is expecting you to have the most niche up to date. Most sort of recent knowledge or niche development and, um, trialed management and stuff like that. It's very much sort of. You're in an acute situation. A patient is unwell. Are you safe enough? Do you have a structure in your head? Do you have the necessary um, uh, knowledge to tackle the immediate problem and start some sort of intervention? No one's expecting you to follow this patient through. No one's expecting you to, um, not the details. And, um, we're gonna sort of focus more on this at the end, but it's about escalating to your seniors asking for help, uh, prioritizing the things that will, um, do more heart harm to the patient first. And I'm sure you've heard all of these, uh, in one shape or form, um, throughout your clinical practice and your clinical placements. Um, but that's something to keep in mind. And for you to not really to try not to stress too much about the station. Um and yeah, I think that brings me to my first case. Uh, brings us to our first case. I will be asking people to volunteer to speak out and, um, interact with me in this session. I appreciate it's 6. 30 almost on Tuesday. Um, so no one, really no one really has Maybe the energy for that. Um But I promise you, you will benefit more if you actually interact. Um, if others interact. And if we have, like, more of a conversation versus just you start blabbing away. Um, if there's no questions so far, um, actually, before I put on the next slide, I do need my first. Do I? I do need my Yes, I need my first volunteer, um, to step up. Uh, I'm gonna do this the way I described the station. I'm gonna give you some information about the patient. We're gonna ask you to summarize it for me, and then someone else will jump along. Say they're differentials. Based on that, someone also jump along, Say some investigations and management, and 1/4 person will then do the sort of communication with, um with a family or with, uh um, with the patient. Does anyone want to volunteer themselves for this? I promise you It's like simple stuff. It's more for you to get acquainted with the station. Hi, Vasiliki. Hi, Fatties. Yes, it is. I I was, like, Perfect. All right. So I won't like I won't give you a time limit. Um, so it may be like in sort of a minute and a half, two minutes. You'll have to obviously to read it. Um, but maybe. But whenever you're ready, just you can, uh, tell me you're ready. Because I will have to change the slide. Basically. Okay, Try now. All right. Perfect. OK, summarize the key findings from the Houston examination. Okay, So 55 year old male presented with a central burning, um, lasting for a couple of hours. Um, the pain is is radiating to the neck, and it's associated with nausea and shortness of breath. Um, but no, Um, no other symptoms such as, um, Vomiting. Um, yeah. Um, he has a history of heartburn, but in this instance, um, and has its did not help. He's on Gaviscon and BP medication as well as metformin. He has, um, 40 year pack history and currently lives with his wife on examination. His heart rate is about 90 BPM. His respirator is 24. He is saturating 94% on room air, and his BP is quite low at about 90/50. Um, his abdomen is soft nontender, but he has bilateral pitting edema around his uncle's. Um, he's a bit dyspneic addressed, but no other. Um, no other signs of cardiovascular or respiratory disease. Okay, I think that's really good. I think you you got the the civilian points. Um, so the what? I have sort of make your sort of highlighted the like in greener, like the things that you would really want to include. So you really well included the age of the patient and what their, um, presenting complaint is. And then I think you did. You did a really nice, um, sort of a shocker. This presentation, and and the way the reason why I put him in a in a picture there is because you you want to use, um, sort of acronyms like that or sort of systematic ways to present, um, information like this. Especially if there are commonly used in practice, because that will help. People have, uh, like, follow the information easier So you started with sort of the site. The onset. Um, you know that the character, like you sort of went through all the information, and it helps you also have, obviously like, um, uh, easier way of remembering things and presenting things and making sure you don't miss anything. Um, so they, uh I think one of the things I would maybe suggest, especially for the purposes of, you know, ensuring you have enough time in the in the actual station and that you're sort of focusing on the really important stuff for the presentation. You basically gave the medication that the patient is on instead. Instead of that, you could have, um said instead of saying the patient's on a form and you could have said, uh, he has a background of, um type two diabetes, um, and hypertension. And and and? And that's it. Um, what else? I am the I thought I thought you were gonna fall into the trap of sort of listing all the negative. So the no cough? No, this? No, that, um but I think you did really well that you mentioned the no vomiting when you were describing the history presenting complaint Because vomiting is, um, uh, sort of a really common, uh, symptom. I guess, uh, in in presentations like this, I'm trying to also not spoil. I'm trying to be sort of, um, cautious about what I'm saying about this presentation, and and then I think your observations you, um it was it was impressive that you remember the the numbers. Um, if you don't in the moment, you might be a bit stressed and, uh, feel like maybe you can't really remember all the specific numbers. It's fine if you sort of go. You know, the patient had an increased oxygen requirement or was saturating low. Uh, with the high with sort of was to keep me ick, um, with an increased oxygen oxygen requirement. Or was hypertensive or you know what? You did say a Parexel at some point. So it's stuff like that. You don't get bogged down too much on on remembering the specific numbers. If you if in the moment you forget them, just try to have an understanding of what the examination sort of showed was, um, tachycardia that keep me up, Um, and all that and great, Um, that was, um I think a really good start. And I'm not going to call a second volunteer to give me sort of, um, they're differentials, Um, that we have sort of structure this if that helps anyone come forward is sort of if you can give me the most, um, most important, most common and most sort of likely to be considering everything. A second one, which might be common, But maybe it's missing some of the information. Um, or some of the information doesn't necessarily fit exactly with, um, with the case and something that really you wouldn't really be thinking right now, But actually, it's important enough that you would like to not miss out if that makes sense. Is anyone brave enough? Yeah, I'll go next. Thank you, Harry. Right. So, what do you think? Um, so are you thinking in acute coronary syndrome? Yeah, Um, other things. I'd also consider this, like, acute heart failure. Okay, Less likely, but important. Is this like a aortic dissection? Yeah, I agree. Exactly. Um, don't worry that I have them. I have, like, slightly different. So I said, like, gourd. Um, it wasn't helped by antacids, but it doesn't. You know, you could still say that God is quite, um, it's quite common. Maybe he's having, like, a bit of a, uh maybe even sort of like peptic ulcer kind of picture. If, like, he's had this background cord, whatever, like it doesn't. The point is, it doesn't matter too much what you say as long as you can sort of justify it in your head. I'm not saying sort of go the other in the spectrum and say that this patient has, uh, uh, you know, all sorts of colitis. Um, but as long as there's something that would make sense with his presentation and that you can justify with the information that you have, um, it's fine. Um, what, What? This sort of framework is trying to get you to do so with the sort of most important, most common something that's common and something that's rare but important to remember is to get you to think about your top three stuff, the top three things that you want to say both for the essence of again time in the station that only last 10 minutes and you don't wanna get carried away and start listing endless possibilities, but also to calm you down a bit and say Okay, you know what? Actually, even if I only managed to that's fine. No one expects you. This is not a number that you're expected to give. Um, it's more like a framework to start to get your sort of thinking about, um what is important enough for me to say in that moment and you can decide that, And that's completely up to you. Um, but yeah, just sort of avoid, uh, listing all the other possibilities. Um, fine. Is there anyone else who just wants to sort of give me an idea of what they would, what they would do and how they would manage this patient? Now that we've established, Yes. This is sort of an in my like a C s. However you want to call it, um, anyone who wants to have a shot at what they would do next. If someone presented to any like this, I don't start picking on people. But I do think that if I go through the presentation, it's not going to be extremely beneficial for you guys. So I do want to to sort of volunteer, even if it's like more than one person for this, um, for this section, and you just want to even write something on the chat. Like, what would you do? Um, yeah, exactly. You can tap on the chat. Like, what would you do for the special investigation ones? Okay. Yeah. Bloods, including Trop says Gen and e C G. Great. Um, sorry. I always try to see what my next slide is because I can't see my next slides, but yeah, exactly. All right. So very good ideas in the chart. So you will do some investigations. And from from your year, I mean three and five, actually, bases and the way that you would like to, um, you know, sort of ex described and categorize those investigations. That sort of bedside bloods and imaging. Um, And you very quickly said that, um, you would do is, uh, actually you would do serialised MGs to six. There's dynamic changes. Um, and I've just written some stuff down that you would, um so in the moment you're gonna say I want to do an e c g at the bedside, they're gonna give you an E C g. And I'm gonna give uscg as well. Now,