StreetDoctors- Student BMJ May 2013

StreetDoctors is an organisation run by doctors and medical students to teach young offenders how to save a life. CPR tends to be the focal point of most first aid courses, however for this target audience, a bleed-focused itinerary is more appropriate. The sessions include discussions of personal experiences alongside formal teaching on how to deal with bleeds. With most of the pupils having witnessed a stabbing, the young people engaged well with the material and understood the importance of protecting the health of their friends and family.

StreetDoctors- established at Liverpool University 2008 

The main message appears to be emphasising the importance of preventing blood loss: if you lose blood your heart and brain stop working, the only place to get more blood is at the hospital. This simple concept is used to teach the children the importance of reducing bleeds and calling for an ambulance.

Personally, I think this is a great scheme. From my experience of teaching at local schools with the BrightWAMS society, young people really engage when provided with fun and relevant interactive sessions. Informing people, particularly those at risk,works to demonstrate that you don't need medical training to be able to save someone's life. Through basic procedures such as calling for an ambulance, raising a limb, applying pressure and bandaging, even young people can potentially make a difference.

The scheme is growing and is currently running at several UK locations. Hopefully it will continue to grow (and come to Brighton!)- I'd love the opportunity to get involved. For more information go to http://streetdoctors.org/

Image: http://www.lucianaberger.com/2012/10/meeting-liverpools-street-doctors/

Carter S.'StreetDoctors; teaching first aid to young offenders'. Student BMJ 2013;21:f2241. Available from URL: http://student.bmj.com/student/view-article.html?id=sbmj.f2241

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Care Assistant Work

Finally back home, after a very busy term!

This summer I will be working as a care assistant again. I have joined an agency where I will be allocated to local residential and nursing homes, as and when I am required. I am interested in how my experiences may differ now that I have had a year of medical training. I like the idea that I should now be able to understand the clients notes better. Hopefully I will be able to apply my pharmacological knowledge to make sense of the clients' side effects and predict what medication they may be on, based on their past and on-going medical history.

Right now I feel like a need a bit of a break from the whole world of medicine. However after I have recovered from my first year and got some more sleep I'm sure it will be a great opportunity to practice my knowledge, develop my bedside manner and earn a little money.

Recovering from a busy term.

An Amazing 1st Year at BSMS

So here we are, a year down the line. I've had some new experiences, made lots of great friends and even learnt how to use my stethoscope.

I don't think  I could have asked for a better start. The transition from my gap year, spent working full-time in care settings, could not have been smoother. Interestingly, most of my flat mates were in the same position as me. Having had a year out to re-apply and gain some life experience seemed to make everyone eager yet a little anxious about returning to an academic setting. It's amazing how little time in takes for you to become attached to people you have only just met. By the end of our first week, we were speaking to each other as if we'd known each other for years! 

The thing that really makes BSMS is the people. I honestly I could not have wished for a nicer year group! Everyone is so friendly which gives the whole medical school a great atmosphere. This is something I really noticed as being different to sixth form; all the students here seem to be passionate, out-going and hard working. On reflection, it wasn't until I started that I quite realised the value of medical school interviews. By looking at the type of students on my course, it seems quite obvious what BSMS were looking for in their candidates. Interview days seems like such a long time ago now!

Overall I feel that the work has been hard, but I've enjoyed the challenge. Plus it feels great to actually be able to recognise medical conditions and abnormalities, as well as understand how and why things work in our bodies. Dissection has been great, I have learnt so much anatomy and developed my cutting skills- I'm still far from a pro, but I'm getting much better at using the bone saw! Also I've become good friends with my dissection group-working as a team has brought a real mix of people together through the unique experience. 

In terms of social life, BSMS is simply amazing! From Freshers Week right through to the end of the year, MedSoc has organised an interesting array of nights out, most of which have included a hilarious fancy dress theme. I also love the Medic Parents scheme, which was introduced to us in our first week. My parents (2nd year students) have been great to me, they've cooked dinner for my Medic siblings and I and throughout the year they've  really looked out for us. I can't wait to be a parent in September, when I'll have my own Medic children to look after. Also, I hope I can keep in contact with my medic parents; this will be a little bit harder as they will be based at the hospital for their 3rd year of teaching. 

 It amazes me at how much I have learnt in just 30 weeks of term-time teaching. As well as learning about the thorax and abdomen, we have also been taught clinical skills. We have recently had our first OSCE which required us to examine the cardiovascular, respiratory and alimentary systems, take peak-flow & blood pressure readings and demonstrate our focused history taking skills. Through our clinical placements we have had the opportunity to practice these skills on real patients in the GP setting, which makes you feel like a real doctor (well sort of!). We also have been on secondary care visits to various hospitals to get an insight into some of the different specialities. In terms of patient contact, in addition to these visits, we have had the opportunity to follow the development of a new born child and the impact it has on their family. I really enjoyed talking to the mother about her experiences as well as having a few cuddles with her beautiful daughter.

Throughout the year I have got involved and joined new societies such as belly-dancing, Sexpression and paediatrics. I have been to local schools through the Teddy Bear Hospital scheme to help reduce reception children's fears of doctors, as well as taking part in dissection art classes and doing a naked calendar to raise money for our chosen charities. This year I have acted as the first year representative for BrightWAMS society, this included writing lesson plans and having meetings with older students to run sessions to teach primary school children about the human body and to inspire them to consider medicine as a career. 

Next year should be just as good, if not better! The work will be tougher, but with placements within A&E, psychiatry and paediatrics, there will be lots of exciting things going on. I will continue to work as a member of the BrightWAMS committee and have been elected the position of secretary. I'm excited to  be moving into a lovely student house in Brighton to live with my wonderful flat mates again. 

After making a silly campaign video, which we filmed in our flat, my best friend and I have been elected as Freshers Reps. This means over the summer we will be working hard to plan the most exciting week of social events in the Medsoc Calendar! We will need to design booklets, wristbands and choose some exciting themes, in addition to organising this year's Medic Parent scheme and communicating with club promoters to book venues. 

Roll on  September!

Ban on Bargain Booze

 

The Government has proposed to enforce a minimum charge of 40p per unit to reduce the nation's binge drinking habits. In the last decade deaths from liver disease has risen by 25% with over 1 million people being admitted to NHS hospitals each year. It is also thought that over 1 million acts of violent crime each year are linked to alcohol.

The minimum charge is unlikely to affect most pubs and large brands. It will be mainly affecting cheap supermarket own brand produce, super-strength drinks and huge bottles of cheap cider which are currently being sold for around 20p per unit of alcohol. For example a 2 litre bottle of 5% cider which is sold at some shops for £1.60 will increase to a minimum of £4.00.
Hopefully the new laws will help reduce the number of casualties resulting from the effects of binge drinking.


Image- http://www.dailymail.co.uk/tvshowbiz/article-1268706/Cut-price-Curran-WAG-stocks-cheap-alcohol-Bargain-Booze.html

Can cooling the brain help our stroke victims?

According to an article reported in several of the national papers and on the BBC website; lowering the temperature of the brain can lead to a greater recovery for people affected by strokes. A pilot study has suggested that a reduction in temperature (35C) using cold saline or ice-packs on the body, appears to put the brain in a form of protective hibernation. It is estimated that this induced hypothermia will help over 40, 000 people in Europe each year; as the therapy has been considered suitable for most stroke victims. 

I have cared for several elderly people who have had strokes and not one of them had exactly the same symptoms. They suffered from a range of speech problems, paralysis and swallowing difficulties however each was affected differently. A treatment which is versatile in reducing the damage to the brain looks like really exciting possibility.

There is already strong evidence that cooling helps reduce the amount of permanent brain damage for those with serious head injuries. The pilot study shows that this technique had potential to help those suffering from strokes, however more research is needed.

Horizon BBC2: Out of Control?

After seeing this advertised, I decided to watch it on BBC iplayer.The programme looked at the role of the unconscious mind in a range of situations by studying human participants. I was particularly interested by how we react to bad news and risks- we are optimists!

 We have an unconscious mechanism which allows us not register bad news as effectively as we take in good news. For example we know that cakes contain 'empty calories' and could lead to us becoming overweight but we still eat them anyway! We often find ourselves living in the spare of the moment and not reading too deeply into the risks. In the study on the programme, the participant had to estimate the risk of developing a certain illness/disease whilst in a MRI scanner. He gives his prediction before finding out the real statistic, most things were grossly underestimated. When he was asked to repeat the set of questions, he did not use the information to change his results. For example when he found out that he was more likely ot be affected by cancer than he thought he still didn't alter his original prediction. The brain scans confirmed that we seem to have a dysfunctional ability to deal with negative information.

 It appears that we live in a world through rose-tinted glasses. Our optimism appears to have been developed for a reason. If we were forever worried that we would fail or take a turn for the worst then our anxiety levels would be through the roof which can contribute to a whole range of other problems (just for starters, think fight or flight mechanisms and how cortisol & other hormones interfere with your immune system). Also if we never thought we were capable of achieving anything then we wouldn't try. If we didn't have this optimistic way of life, I wouldn't have had the motivation to apply for medical school with only 5-10% chance of success from most of them, the odds were completely against me! That's enough for me to consider it an amazing mechanism.

I love watching this sort of thing, especially when I can link it back to my existing knowledge of science. I cant wait to get back into learning, only 6 months to go now!

Abortion Clinics Ads (Student BMJ March 12)

 

As of 30 April 2012, private abortion services which charge a fee will be able to advertise on the television and radio. Profiting companies will be allowed to broadcast their services alongside the existing non-profitable clinics. For some women this will make the termination of a pregnancy easier as they may be more aware of the services available however some worry that we may become desensitized to a very emotional and controversial subject. I think it is important that people think very carefully about their actions; the media may be portraying it as an easy and winning option, however we need to be careful not to over simplify such a life changing decision.

UK Doctors Abort on Gender Alone

 

The Abortion Act 1967 states that non-medical reasons for abortion are illegal in England, Scotland and Wales. Reports in The Daily Telegraph discovered that doctors have secretly been allowing the termination of a pregnancy based n the sex of their child. Secret filming found three clinics guilty of allowing sex-selection based abortions. Andrew Lansley has reported those involved to the GMC and to the police for their criminal actions. Doctors who partake in this illegal activity run the risk of being struck off and imprisonment.
Two doctors are needed to consent the abortion of an unborn child before reaching 24 weeks. The only accepted reasons for termination are that the pregnancy poses as a risk to the mother or her existing children's health (mental, physical) or that there is a significant risk that the child will be seriously disabled (physically or mentally). By abiding to these rules, the one way gender could play a part is if a) the child's sex significantly affects mothers mental health or b) there was a significant chance that the child may develop a disability based on X/Y chromosomes.

Sexual health with older patients (Student BMJ)

When diagnosing older patients, the chances of it being an STI would be fairly low down on a doctor's list, however research has shown that more than 80% of people aged 50-90 are sexually active. It has become apparent that Sexually transmitted infections are increasing in the older generations, however there hasn't been enough research  to explain why. As women get older they are physiologically more vulnerable to minor genital injuries after the menopause.When looking at improving the situation, it is difficult to know which strategies to use to improve awareness and control the spread of infection. Doctors have been discouraged to shy away from discussing save sex with patients regardless of age.

Vera Drake

Recently I watched this film and it made me think about people's attitudes towards abortions. Set in 1950's London, Vera, a nurturing motherly figure, is performing backstreet abortions to 'help girls out'. She uses household items and flushes them with soapy water to stimulate a miscarriage. With only the wealthy being able to afford to staying in a nursing home for the termination of their pregnancy, many women come to Vera for help. Not only does Vera have no medical training or sterile equipment, she is not able to offer the psychological support that healthcare professionals could offer.
Although Vera has a heart of gold and means no harm, one of the girls she helped takes a turn for the worst and her case becomes life threatening.Vera had never seen her actions as wrong however she was wrecked on hearing the news. The police soon get involved and her family learn of her private life. Her son in particular, presents as being emotionally distressed after finding that his Mum 'kills little babies'. She is sentenced for two and half years imprisonment.
 If abortions were made illegal in the UK, it worries me that these illegal and uncontrolled practices may take place again. When I think about not being able to get the right treatment or any medical attention to that matter, it makes you really appreciate having the NHS with free healthcare at the point of call. Also without proper support and counselling, people may be a risk to themselves or others. With the stigma of mental health reducing over time people, psychological support is more available and possibly more importantly, it is more accepted.

Trailer for Vera Drake (2004) http://www.youtube.com/watch?v=_5L3hGxHumY