APEARTD

Acute myeloid leukemia (AML) is caused by malignant transformation of the hematopoietic stem cells. It is predominantly seen in individuals between the ages of 50 and 60 years and is characterized by the arrest of leukocyte development in the early stage of development. Diagnosis is based on the presence of blast cells in the peripheral circulation. AML is treated by chemotherapy, which includes treatment of remission and post-induction remission. Refractory cases of AML are treated by bone marrow transplants. Complications of AML include anemia, infections, and bleeding as well as acute medical emergencies such as necrotizing enterocolitis, hyperleukocytosis, and tumor lysis syndrome. Table of Contents Definition of Acute Myeloid Leukemia Epidemiology & Etiology of Acute Myeloid Leukemia Classification of Acute Myeloid Leukemia Pathophysiology of Acute Myeloid Leukemia Clinical Examination and Symptoms of Acute Myeloid Leukemia Diagnosis of Acute Myeloid Leukemia Th

file:///C:/Users/acer/Downloads/Commissioning%20guide%20for%20varicose%20veins_Published.pdf https://www.nice.org.uk/guidance/cg168

http://www.worcestershireloc.com/useful-resources-for-opticians/ https://cds.bromley.gov.uk/documents/s50063749/App.%201%20to%20Bromley%20Minor%20Eye%20Conditions%20Service%20Pilot%20Update%20CCG.pdf

RECOGNISING SEPSIS The clinical diagnosis of sepsis may be obvious, such as when someone presents to the emergency department with community acquired pneumonia or a perforated viscus; however, in other circumstances and when onset is more insidious the diagnosis of sepsis is often missed. Early diagnosis and prompt treatment is essential as each hours delay in administering antibiotics increases risk of death by close to 8%  (6) . Compliance with international guidelines for the management of sepsis remains low even in countries where the guidelines have been embraced  (7;8) . Sepsis occurs as a result of infection, signs suggestive of infection include: Fever and/or rigors Hypothermia Cough, increased sputum production or dyspnoea Abdominal pain or distension Dysuria, urinary frequency, odour New onset confusion or decreased level of consciousness Recent surgery or invasive procedure with cellulitis or wound infection Line associated redness/swelling/pain Painful sw

Parameters respiration rate oxygen saturation systolic blood pressure pulse rate level of consciousness or new confusion* temperature. inspired oxygen What NEWS does?  • It provides a baseline measure of an individual’s physiological functioning (from a gathered sequence of vital signs recordings);  • It measures the effectiveness of some treatment interventions when there is a change in NEWS;  • It provides a risk assessment of an individual based on recorded observations;  • It can assist in timely escalation of clinical response in the event of an acute physiological deterioration when there is an increase in NEWS. Example Scenario Mr Smith is 52 year old gentleman who attends the emergency department with fever, cough and pleuritic pain with following vitals: Respiratory rate: 21/min Oxygen saturation : 93% On air Systolic blood pressure: 120 mmHg Heart rate : 95/min Consciousness: Alert Temperature: 38.5 °C What is SBAR ?  SBAR