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Richgeridoc | This site is a series of essays where I give an overview of current medical issues relevant to GPs and GPSI elderly medicine, and other professionals who work in community hospitals in the care of the elderly .It will also be useful to medical students and doctors in training who are interested in the care of the elderly and those considering doing the Diploma in Geriatric medicine. - This site is a series of essays where I give an overview of current medical issues relevant to GPs and GPSI elderly medicine, and other professionals who work in community hospitals in the care of the elderly .It will also be useful to medical students and doctors in training who are interested in the care of the elderly and those considering doing the Diploma in Geriatric medicine.

  • https://rickolddoc.wordpress.com/2015/01/13/acute-treatment-of-cva-in-secondary-care/ Acute Treatment of CVA in Secondary Care | Richgeridoc - The patient with a suspected stroke is admitted to the local DGH . Guidelines on who gets an immediate CT ie withing one hour were published by NICE in 2008. Perform brain imaging immediately if any of these apply: indications for thrombolysis or early anticoagulation treatment on anticoagulant treatment a known bleeding tendency a depressed…
  • https://rickolddoc.wordpress.com/2014/11/16/strokes-and-nice-guidance/ Strokes and NICE Guidance | Richgeridoc - The NICE Guidelines for Stroke treatment in the UK were reviewed in May 2014 and were based on  a document published in 2008.  In a series of essays I will explore and interpret these guidelines and show their practical application to the GP on the ground. Most GPs want to know how fast to recognise…
  • https://rickolddoc.wordpress.com/2014/09/26/benzodiazepines-and-alzheimers/ Benzodiazepines and Alzheimers | Richgeridoc - Benzodiazepines and their side effects with regard to Alzheimer's are discussed in this weeks BMJ. In a linked paper , Billioti de Gage and colleagues examine  this link and their results suggest that LONG TERM exposure to benzodiazepines might be a modifiable risk factor for this condition. The study involved 2000 elderly in the province…
  • https://rickolddoc.wordpress.com/2014/09/17/dols-in-the-community-hospital/ DoLS in the Community Hospital. | Richgeridoc - The Deprivation of Liberty Safeguards (DoLS) are part of the  English Mental capacity Act of 2005 . They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The safeguards should ensure that a Hospital  or supported living arrangement only deprives someone…
  • https://rickolddoc.wordpress.com/2014/09/01/uti-s-in-the-elderly-a-bmj-review-2/ UTI s in the Elderly. A BMJ review. | Richgeridoc - A suspected UTI is very common in the elderly.They often present to the Emergency Department as the confused elderly who is " off legs" . Patients are often therefore not able to give a history.However it needs to be noted that prevalence of asymptomatic bacteruria is very common in elderly people. ( Upto 50 % of…
  • https://rickolddoc.wordpress.com/2014/08/26/myelodysplastic-syndrome/ Myelodysplastic Syndrome | Richgeridoc -   One of the most frequent short stay patients in the community hospital is the patient receiving a blood transfusion.The in and out patient will be there for only 24 hours and helps with the " patient throughput figures" which are beloved by hospital managers. Commonly the elderly patient will be suffering from MDS or 'myelodysplastic syndrome . The…

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