Junior doctor survival kit
You’ve been bleeped: symptom control in the unwell patient
- By: Richard Kitchen, Nicholas Budhram
As a junior doctor you need to know how to recognise a deteriorating patient and to initially manage symptoms that the patient may be experiencing, such as pain, breathlessness, and nausea. This article shows you how to work out the causes of pain in a patient who has gastric cancer and who is deteriorating, so that you can formulate an appropriate management plan.
When approaching a case of a deteriorating patient, both the “here and now” and more long term plans should be considered. Treat symptoms promptly to prevent suffering. When deciding on a definitive management plan, the potential benefits and burdens of any investigations and management should be weighed up and a decision made together with the patient. As a foundation year doctor, it is generally always helpful to involve senior clinicians in decisions about cardiopulmonary resuscitation, and in complex decisions such as setting ceilings of care and withdrawing