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Okay, hopefully we're back. So I've got some questions, gives burdens of persisting with these guys. Um, we'll think about solutions to this cutting out after I'm saying After blood sugar comes to find, what else do we give the maintenance? So that depends. So what for? For Lucy. She's very unwell. So we're going to continue our A to me anyway, and we're going to reassess. Hopefully a GCS comes back up. And if a GCS comes back up, there's no reason why we can't give some some long acting carbohydrates all. Really, If it just stays low, then we need to think about other forms of maintenance. Whether we run some slow glucose sensor, for example, we have to think about that. Depending on your response, we need to think about our renal failure patients in particular. So if they're on insulin, actually think intravenous metabolized release that might stay in the system a bit longer. So if it's due to, uh, over administration eventually and actually we could probably do need to think about a slow bleed coast infusion, um, just made a point that maybe we should stop insulin and not give unless the patient is eating treat and extent, but we shouldn't really ever stop long acting insulins if she is on Lantus Insulin. If we actually remember the see history, she what did I give you? The history? She's not in on any insulin, but we probably shouldn't stop long acting. But we need to think about omitting short acting or adjusting insulin. Dose is certainly we know the definitive strategy for that. But again, we can think about that after I ate the operation was all right to the approach is solely based upon Let's get the shot. Trouble is getting some sleep blanket. Any more questions? Or is that okay? It's okay. In our case, Lucy, uh, her GCS recovers and we give us, um or how hydrates and we're We're all happy after that. Um, and then we're going to think about courses of why get my questions get why she dropped her blood sugar, because it's not normal someone to see that silly. But it can happen on dialysis. Okay? Yeah. Um, Peter's something that I can think of that someone beginning with a e. Let's go for the approach. And then we're nearly done, and we can have a lot of guys say, Doctor, Please, can you assess feet? It's the plain of a lot of pain. Is already had 10 mg of water or more from the last four hours. So quite a lot. And he's still complaining. Arriving in pain. Carpenters 80 years old. He's got background of quite advanced outside. And so you can't get your history. He's got hypertension. CKD stage two There's had a previous hernia repairs. What gorgeous. A previous MRI And cabbage has got quite a next NSAID medical history. He's only in for social reasons that you're struggling at home and he's awaiting placement in a care home, and we're not treating and for anything at the moment, But we have no force for this pain. Um, have we done a bit of an eight to a Yes. Give me before you run it for everyone. Um, how are we going to approach Peter? Give me, uh, skip me or steps. What approach? We're going to take on. What are we gonna taper? Don't give any history. It'll might talk for some of it because I know delays slow just probably have things to do tonight. Beyond listen to me. How are we going to assess pizza? I'm on the main or be acutely unwell. Uh, be kind of any history. And we don't really know why he's in pain step minnows, so we might check the notes. Yet on back, history is has already presented itself. So we know remission. He's got that. Brown hasn't really been treated for any medical issues. His bloods today, we're We're done a few days, though. They were normal, his opposite been normal nursery collaterally street nurse doesn't know it's 2 a.m. Do you want me to bring up the family doctor? No, not quite yet. Good job we're going to do in a to me approach, obviously, because of this session, Very good on also because it's a really useful way to pick up important information when you really have no idea what's going on. So that's starting natively. Very good, because there are many sources of pain that he's Peter these pizzas and you can't give us much of a history. So we look in for the end of the bed and he's clearly uncomfortable. He's kind of grimacing in pain. Sit bowl by the side of the bed. No one took. It's important to look around. The bedside is let it 45 degrees responding or there's clearly confused. And the nurses he's been like this for hours admission. So let's assess it for a pizza. And he's being sick. By the looks of that. Is there a way his own, Which is good, Um, and it's just