These are usually commissioned by the editorial team in accordance with a cycle running over several years. Authors wishing to submit a review relevant to Acute Medicine are advised to contact the editor before writing this. Unsolicited review articles received for consideration may be included if the subject matter is considered of interest to the readership, provided the topic has not already been covered in a recent edition. Review articles are usually 3000-5000 words and may include tables, pictures and other figures as required for the text. Include 3 or 4 ‘key points’ summarising the main teaching messages.

The review articles for the journal 'Acute Medicine' are usually commissioned by the editorial team based on a multi-year cycle. Authors wishing to submit a review relevant to 'Acute Medicine' are advised to contact the editor before writing. Unsolicited review articles may be considered if the subject matter is of interest to the readership and has not been covered in a recent edition. Review articles typically range from 3000 to 5000 words and may include tables, pictures, and other figures as needed. Authors should include 3 to 4 'key points' summarizing the main teaching messages.

《Acute Medicine》期刊的审稿通常由编辑团队根据多年的周期进行委托。希望提交与《Acute Medicine》相关的综述文章的作者，建议在撰写之前先与编辑联系。若收到的非请求性综述文章的主题被认为对读者有兴趣，并且该主题在近期的期刊中尚未被覆盖，则可能会被纳入考虑。综述文章通常为3000-5000字，可能包含表格、图片及其他所需的图形。请包括3到4个‘关键点’，总结主要的教学信息。

Acute Medicine

The screen time app on my iPhone tells me that I spend over ten hours a week on Twitter. And I’m not alone. As Netflix’s The Social Dilemma illustrated, social media platforms are designed to keep us scrolling for hours, even if we only opened the app for a second. Thousands of UK healthcare workers use Twitter every day, discussing everything from cutting edge COVID treatments to staff room fridge etiquette. As strange as it sounds, this esoteric little corner of the internet – affectionately if unoriginally nicknamed “MedTwitter” – has become a thriving online community.

Z Ferguson

Acute Medicine Journal

What role should social media play in the future of acute medicine?

社交媒体在未来急性医学中应扮演何种角色？

A patient with patent ductus arteriosus presents with seizure after haemodialysis. Although conscious on arrival to the emergency department with spontaneous limb movement, he develops recurrent convulsion and left hemiparesis after admission. The approach to the haemodialysis patient presenting with seizure is discussed and the role of early hyperbaric oxygen therapy for an uncommon but important diagnosis is highlighted.

Stephanie Dorothy Pui-Ming Yu

James Siu Ki Lau

Mind the bubbles – A patient presents with seizure after haemodialysis

注意气泡——一名患者在血液透析后出现癫痫发作

Overuse of corticosteroids is an important problem not only in asthma but also the management of other airways diseases including bronchiectasis and COPD and results in associated risks of serious side effects and irreversible harm. We report a pilot using an in-reach solution to review patients, optimise their care and facilitate early discharge. We discharged &gt;20% of our patients immediately, which is potentially a significant reduction in hospital bed use and, most importantly, through this approach we were able to establish early diagnosis and reduce inappropriate oral corticosteroid use.

Alain AlHelou

Alastair Watson

Kirsty Russell

Kayleigh Jones

Hayley Johnson

Gajan Chellappah

Rahul Mukherjee

Technology-enabled multidisciplinary team in-reach for oral corticosteroid stewardship and optimizing care of suspected airways disease exacerbations

技术支持的多学科团队入院服务用于口服皮质类固醇管理及优化疑似气道疾病急性加重患者的护理

Waiting times are the most widely used indicator of patient flow. This project aims to analyse 24-hour variation in referrals and waiting times for patients referred to the Acute Medical Service (AMS). A retrospective cohort study was conducted at the AMS of Wales’ largest hospital. Collected data included patient characteristics, referral times, waiting times and adherence to Clinical Quality Indicators (CQIs). Peak referral times were found between 11:00-19:00. Peak waiting times occurred between 17:00–01:00, which was longer on weekdays in comparison to weekends. Referrals between 17:00-21:00 had the longest waiting times with &gt; 40% of patients failing both junior and senior CQIs. Mean and median age and NEWS were higher between 17:00-09:00. Weekday evening and nights are problematic for acute medical patient flow. Interventions, including workforce, should be targeted towards these findings.

C H Wood

J Underwood

C Davies

P N Taylor

Patient Characteristics and Variables Influencing Acute Medical Flow

患者特征及影响急性医疗流程的变量

NHS urgent and emergency care is under intolerable strain. This strain is increasingly causing harm to patients. Timely and high-quality patient care is often not being delivered due to overcrowding driven by workforce and capacity constraints. This drives low staff morale perpetuating burn out and high absence levels which currently dominate. Whilst COVID19 has accentuated and arguably expedited the crisis; the spiral of decline in urgent and emergency care has been decade long and unless urgent action is taken, we may not yet have reached its nadir.

Tim Cooksley

Editorial - The NHS urgent and emergency care crisis: how much worse could it get?

社论 - 英国国民保健体系紧急和急诊危机：还能更糟到什么程度？

Cardio-Renal-Metabolic (CaReMe) diseases, in the form of heart failure, chronic kidney disease and diabetes mellitus, justify prescription of multiple prognostically beneficial medications, specifically renin-angiotensin system inhibitors, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter-2 inhibitors. Use of these medications is complicated by association with adverse effects, particularly acute kidney injury and hyperkalaemia. Balancing risk and benefit is a common dilemma in acute medicine, with increasingly frequent and complex treatment decisions. Physicians should contemplate adjustments to medications within the context of not just acute illness but also long-term benefit. In the setting of hyperkalaemia, potassium-binding medications can be utilised. At hospital discharge optimisation of therapy can be achieved through clear safety netting advice, scheduled biochemical follow-up, and planned clinical review.

Benjamin David James

Mark Holland

Darren Green

Balancing acute medical management of acute kidney injury and hyperkalaemia versus medicines optimisation for long-term Cardio-Renal-Metabolic (CaReMe) diseases: a narrative review

急性肾损伤和高钾血症的急性医疗管理与长期心血管-肾脏-代谢（CaReMe）疾病药物优化的平衡：一项叙述性综述

Chatbots hold great potential to serve as support tool in diagnosis and clinical decision process. In this study, we aimed to evaluate the accuracy of chatbots in diagnosing pulmonary embolism (PE). Furthermore, we assessed their performance in determining the PE severity.

Banu Arslan

Mehmet Necmeddin Sutasir

Ertugrul Altinbilek

Performance of AI-powered chatbots in diagnosing acute pulmonary thromboembolism from given clinical vignettes

基于人工智能的聊天机器人在根据临床情景诊断急性肺血栓栓塞症中的表现

This is a case report of a patient who presented with neck pain and intermittent pyrexia as a manifestation of pseudogout of the neck.

Benjamin Fox

Tom Jaconelli

Crowned Dens Syndrome-Pseudogout of the Neck

颈冠综合征-颈部假性痛风

Headache accounts for 1 - 3% of emergency department (ED) visits globally and is associated with elevated blood pressure (BP). It is unclear if anti-hypertensive therapy provides benefits. This retrospective study assessed effects of anti-hypertensive therapy in ED headache patients on rescue analgesic need, hospital admissions, and length of stay (LOS). 1385 patients were included. 366 received anti-hypertensive therapy. The anti-hypertensive therapy cohort was older (p < 0.001) with increased odds of admission (p < 0.001) and 2.385 hrs longer ED LOS (p < 0.001). No difference in rescue analgesia was found (p < 0.429). Anti-hypertensive therapy in hypertensive ED headache patients is associated with increased hospital admission and ED LOS, but no difference in rescue analgesia utilization.

Lauren Eberhardt

Michelle Jankowski

Brett Todd

Emergency Department Treatment of Elevated Blood Pressure in the Headache Patient

急诊科对头痛患者高血压的治疗

Emergency departments are under year-round pressure, driven by high hospital bed occupancy and compounded by increasing attendances and admissions. In 2023, 1.5 million people waited 12 hours or more for a bed. Long waits are associated with increased mortality and there is a disproportionate impact on people living in more deprived areas. Addressing this problem begins with unity of purpose and vision, such that we all view emergency department performance as our responsibility, whatever our place in the healthcare system.

ISSN	1747-4884, 1747-4892
h-index	15

Publication Information	Publisher: Rila Publications Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2005，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Acute Medicine

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