Hot Topics Flashcards
What is an overview of the story of Dr Bawa Garba?
. 18th January 2011, Jack Adcock was admitted to the Royal Infirmary Leicester after feeling unwell. He had fever, vomiting and diahroea. He had down syndrome a heart condition and was on long-term medication
. He was treated by a junior doctor Bawa Gaba who was a paediatric registrar 6 years into her specialist training.
. Jack died of sepsis and Dr Bawa Gaba was charged with gross negligence
Give a breakdown of the events of the Dr Bawa Gaba case?
. Jack was given an x-ray which showed an infection. This was available at 12:30 but was seen by Bawa Gaba at 3:00. She treated him with antibiotics at 4:00 as she was extremely busy and the hospital was understaffed.
. A blood test revealed Jack had high levels of infection and inflammation but this was seen 5 hours late because of failings in the hospital system
. Dr Bawa Gaba stopped Jacks heart medication but didn’t write it down in his notes and his mother mistakenly gave him a dose at 7:00pm
. Jack suffered cardiac arrest at 8:00pm and Dr Bawa Gaba mistook him for another patient that had a DNR so she stopped ressusitation. The boy ended up dying from septic shock at 9:20pm
What were the mistakes made my Bawa Gaba?
. Didn’t check the x-ray for 3 hours
. Didn’t administer antibiotics for another hour after she knew which could’ve resulted in a different outcome for him
. Didn’t write down or inform the mother not to give heart medication
. Mistook Jack for another patient and didn’t allow resuscitation
. She didn’t review results about the patient when handing over to the consultant on the next shift
What mistakes were made by the NHS (Bawa Gaba)
. Understaffed and Bawa Gaba was doing the work of 2 doctors
. No notification for when an x-ray was complete
. Computer failings delayed blood work for 5 hours
What lessons were learned from the Bawa Garba case?
. Changes in hospital protocol including better registration and safety concerns
. Improvements in computers and less tech failings
. Discussion about stress and work overload of doctors
. Some doctors suggested doctors should lie about when you’ve made a mistake
What happened after the Bawa Gaba case?
. Dr Bawa Gaba was struck off the GMC
. many doctors organisations raised awareness about the stresses that doctors face to place her actions in the context
. The decision to strike her off the GMC was overturned
. The UK government released a set of reforms in response to the case
What is the ageing population?
. An ageing population is one in which the proportion of older people is increasing
. Currently 3.2 million people over the age of 80 but will be 8 million by 2050
. Ageing populations are a result of increasing life expectancy and decreasing birth rate resulting in smaller younger generations.
. This is because of improved healthcare and a switch to diseases being the main cause of death. Decreased birth rate is because of people having fewer children and later in life
Stats and figures about the ageing population
. 81.52 years is the average life expectancy
. 62 is the health life expectancy and government wants to increase this by 5 years by 2035. They would do this by decreasing the bad habits people have like smoking and bad diet and encourage healthier things like exercise
. Individuals over 85 are said to cost the NHS £7000 per person and the spending per person increases rapidly after the age of 50
. One in six elderly people have dementia as so a lot is spent on their daily care
What are the consequences of an ageing population?
. Higher prevalence of chronic and degenerative diseases which can act as comorbidities and require complex treatment across different departments
. Older people have more complicated illness and require longer more repeated hopstial stays
. Increased lifespan and improved care means some will require longer care which affects need for beds and hospital capacity
. Costs for providing care increase including staffing, medication and services
What is bed-blocking?
Bed blocking is the term used to describe delaying the transfer of care. An example of this could be an elderly person experiencing a fall and then it can take weeks for them to be discharged
What is obesity?
. The WHO defines it as abnormal or excessive fat accumulation that may impair health
. Overweight is a BMI of 25 or over
. Obesity is a BMI of 30 or over
. BMI calculation is Weight/ Height squared
What contributes to obesity?
. Incorrect food consumption . Lack of activity . Stress . Lack of sleep . Health and medication . The environment . Genetics
What is Prader-Willi syndrome?
. It’s a genetic condition caused by a loss of function of certain genes on chromosome 15 due to no paternal copies being inherited
. It affects the hypothalamus which is involved in hormone production leading to hormonal changes
. This leads to an insatiable appetite, that drives obesity
. No direct cure for obesity but consequences can be treated
What is Prader-Willi syndrome?
. It’s a genetic condition caused by a loss of function of certain genes on chromosome 15 due to no paternal copies being inherited
. It affects the hypothalamus which is involved in hormone production leading to hormonal changes
. This leads to an insatiable appetite, that drives obesity
. No direct cure for obesity but consequences can be treated
What are the consequences of being obese to the person?
. Increased risk of chronic conditions like fatty liver disease, heart disease, cancer etc..
. Worse mental health outcomes and poor quality of life
. Affect quality of care as some doctors have been shown to have weight bias which can affect treatment
. Affect ability to perform exercise and participate in certain activities
What are the consequences of being obese to the person?
. Increased risk of chronic conditions like fatty liver disease, heart disease, cancer etc..
. Worse mental health outcomes and poor quality of life
. Affect quality of care as some doctors have been shown to have weight bias which can affect treatment
. Affect ability to perform exercise and participate in certain activities
What are the consequences of being obese to the NHS?
. Overweight and obesity-related conditions are costing the NHS £6.1 billion per year
. Over the last 5 years, there have been 20% increase in hospital admissions linked directly to obesity
. Cost of campaigns seeking to prevent obesity alongside that of treatment
. 1 in 5 children leave primary school with obesity
. 2/3 of adults also living with obesity
