Concise - CHD, alcohol, drugs, eating disorders Flashcards
duties of a Dr
- Make the care of your patient your first concern
- Keep your professional knowledge and skills up to date
- Treat your patient politely and considerately
- Respect your patient’s right to confidentiality
- Listen to patients and respond to their concerns and preferences
- Never discriminate unfairly against patients or colleagues
- Work with colleagues in the ways that best serve patients’ interests
- Treat patients as individuals and respect their interest
Some duties conflict
what can Drs do for those with CHD risk?
Identify depression/anxiety Ask about occupation Liaise with social support services Vascular screening Risk reduction through promoting healthier lifestyles
benefits of alcohol consumption
- Mildly euphoriant for many
- Socialization
- Cardioprotective in low doses
psychological effects of excessive alcohol consumption
- Interpersonal relationship problems (violence, rape, depression or anxiety)
- Criminality/violence
- Problems at work/unemployment
- Social disintegration (poverty)
- Driving offences
withdrawal alcohol symptoms
- Tremulouness: ‘the shakes’
- Activation syndrome: tremulouness, agitation, rapid heart beat, high bp
- Seizures
- Hallucinations
- Delirium tremens
UK alcohol limits
Men: 3-4units/day
Women: 2-3units/day
Pregnant women: avoid alcohol altogether, never more than 1-2 units once or twice a week
1 unit of alcohol
8g/10ml of pure alcohol Half a pint of beer Small glass of wine Single measure of spirits = Strength of drink (%ABV) x amount of liquid (ml) / 1000
fetal alcohol syndrome
Pre and post-natal growth retardation
CNS abnormalities: mental retardation, irrability, incoordination, hyperactivity
Craniofacial abornalities, Congenitial defects, increase in incidence of birthmarks and hernias
Primary prevention (health promotion) of alcoholism
Drinkaware – alcohol labelling THINK! – drink driving campaign ‘Know your limits’ binge drinking campaign Restriction on alcohol advertising Minimum pricing Legislation – e.g. age limit Opening hours Glass substitution
Secondary prevention: screening & intervention
Ask about it routinely using screening questions/tools
Detect problem drinking (including laboratory tests)
What can doctors do for alcoholics?
- Screening: CAGE and Alcohol Use Disorders Identification Test (AUDIT)
- Brief interventions: FRAMES
- Referral to specialist
- Help set goals, agree on plan, provide educational materials
signs of alcohol abuse
- Role failure
- Relationship problems
- Run-ins with law
- Risk of bodily harm
alcohol dependence (3+ in the last 12 months)
- Withdrawal symptoms
- Tolerance
- Keep drinking despite problems
- Cannot keep within drinking limits
- Spend a lot of time drinking/recovering from drinking
- Spend less time on other impt matters
FRAMES: motivational interviewing
- Feedback about the risk of personal harm or impairment
- Stress personal Responsibility for making change
- Advice to cut down or, if necessary, stop drinking
- Provide a Menu of alternative strategies for changing drinking patterns
- Empathetic interviewing style
- Self efficacy: intuitive style which leaves patient enhanced in feeling able to cope with goals they have agreed
treatment for alcoholism
drugs
behavioural therapy
social support - AA
stop smoking
- Ready: mentally prep yourself, understand process
- Steady: throw away ashtray, lighter, set quit date
- Stop: reward yourself for not smoking, avoid triggers
Occupational screening
- What type of work do you do?
- Do you think your health problems might be related to your work?
- Are your symptoms different at work and at home?
- Are you currently exposed to chemicals, dusts, mentals, radiation, noise or repetitive work? In the past?
- Are any of your co-workers experiencing similar symptoms?
Occupational good work
- Precariousness – stable, risk of loss, safe
- Individual control – part of decision making
- Work demands – quality and quantity
- Fair employment – earnings and security from employer
- Opportunities – training, promotion, health, growth
- Prevents social isolation, discrimination & violence
- Share information – participate in decision-making
- Work/life balance
- Reintegrates sick or disabled whenever possible
- Promotes health and wellbeing – psychological needs
first aid
- Assess the situation – do not put yourself in danger
- Make the area safe
- Assess all casualties and attend first to any unconscious casualties
- Send for help – do not delay
- Gently shake the casualty’s shoulders and ask loudly, ‘Are you all right?’ If there is no response:
- Shout for help (call 999)
- Open the airway
- Check for normal breathing
- Take appropriate action: 30 chest compressions, 2 rescue breaths, repeat
first aid ABC
Airway: place your hand on the casualty’s forehead and gently tilt the head back; lift the chin with two fingers
Breathing: look for chest movement; listen at mouth for breath sounds; feel for air on your cheek
CPR: arms straight, centre of breastbone 5-6cm, rate: 100-120times/minute
sustainable healthcare
Global warming -> change to diseases
Change to the way we deliver care (reduce waste, recycle, think of environmental consequences)
NHS Carbon Footprint: 18.6mill. ton, 25% of public CO2
Intervention: Take a walk, not a pill
-exposure to natural environment reduces disorders
substance misuse
Substance misuse: Ingestion of a substance affecting the CNS which leads to behavioural and psychological changes, implicitly non-therapeutic use
types of substances for misuse
opiates, depresseants, stimulatns, hallucinogens
addiction
Physical + Psychological dependence
