GASTROENTEROLOGY
GASTROENTEROLOGY
Embedded Files
GASTROENTERITIS
GASTROENTERITIS
ABOUT THIS SESSION
ABOUT THIS SESSION
This is a self-directed learning resource designed to be worked through in the clinical environment.
Learning objectives:
Learning objectives:
- Demonstrate structured history-taking and examination technique on a patient with suspected gastroenteritis
- Suggest five differential diagnoses for diarrhoea and vomiting
- Understand initial management of a patient presenting with gastroenteritis
- Understand components of common IV fluids and prescribe IV fluids appropriately for a patient with gastroenteritis
Total time:
60 minNumber of students:
1-5Grade of students:
3rd to 5th year medical studentsCreated by:
Dr Charlotte HaydenUploaded:
29th October 2019Last updated:
29th October 2019Resources needed for this session:
Resources needed for this session:
Prescription chart, pen, paper, bags of common IV fluids e.g. Hartmann's, normal saline
Resources linked to this session:
Resources linked to this session:
None
Activity 1: History Taking
10 minActivity 1: History Taking
Take a focused history from a patient presenting with possible gastroenteritis. Include presenting complaint, past medical history, drug history and social history. Remember to observe appropriate personal protective equipment and infection control policy.
Examine the patient using a structured ABCDE approach.
Activity 2: Case-Based Discussion
10 minActivity 2: Case-Based Discussion
At this point, consider:
- What differential diagnoses have you considered?
- What are the common causes of infective gastroenteritis?
- What investigations would you consider?
Activity 3: Applied Clinical Science
5 minActivity 3: Applied Clinical Science
Using the NICE Algorithm for IV Fluids available here, calculate fluid, sodium and potassium requirements for the patient you have seen.
Consider the stages of shock (see table opposite). Review the notes for the patient you have seen and try to grade the degree of hypovolaemic shock.
What do you understand by the terms resuscitation and maintenance fluids?
Activity 4: Prescribing
10 minActivity 4: Prescribing
Find a few bags of common IV fluids e.g. Hartmann's, normal saline and 5% dextrose. You may have to ask the nursing staff to help you find them in the treatment room. Look at constituents of each bag.
Find a drug chart and using these fluid bags and your calculations above, prescribe the following:
- Appropriate resuscitation fluids that would have been given at initial presentation.
- Appropriate maintenance fluids for 24 hours following initial resuscitation.
Discuss your choices with a doctor if possible.
Activity 5: Prescribing
5 minActivity 5: Prescribing
Find the local infection control protocol for patients with infective gastroenteritis.
Consider:
- Have all the relevant precautions been taken with respect to this patient?
- How might you manage an outbreak of gastroenteritis on a ward?
- Which professionals would need to be involved in managing an outbreak of gastroenteritis on a ward
- What would be their role(s)?
Summary and Feedback
Summary and Feedback
Highlight three key things you have learned today. Summarise them on a post-it note and keep it somewhere you will find in a week or two.
Found this useful? Please leave some feedback.
References and Further Reading
References and Further Reading
- https://www.frca.co.uk/article.aspx?articleid=295
- http://www.oxfordmedicaleducation.com/emergency-medicine/shock/
- https://www.nice.org.uk/guidance/cg174/resources/intravenous-fluid-therapy-in-adults-in-hospital-algorithm-poster-set-191627821
- https://www.nice.org.uk/media/default/sharedlearning/328_328infocards1.ppt
- https://litfl.com/hypovolaemia/
- https://www.researchgate.net/figure/Classification-of-hypovolemic-shock-68_tbl2_227027828
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