Simulated ward round: reducing costs, not outcomes

Ward round--a football injury?

Introduction A boy aged 12 presented with pain in his left leg and inability to walk. He said that his symptoms started 6 months previously after a fall while playing football. He had increasing pain in his left leg and for the last 3 months he had a discharging sinus from his tibia. On examination he was apyrexial and appeared poorly nourished. Pulse was regular at 90, BP 110/70 mmHg, with nor...

The Thinking Doctor's Ward Round

Why the ward round? For folks of a certain age the very mention of ward rounds may conjure up the image of Sir Lancelot Spratt barking orders to an entourage of junior staff following in his wake. Whilst we no longer practice in such a hierarchical world, I fear we have neglected the importance of the ward round and with it the importance of the clinical decision making process itself. If you a...

Please Don’t Disturb! Ward Round in Progress: a QI project on reducing the number of interruptions during ward rounds

Are there two kinds of ward round?

CONSULTANT: Are we agreed then ? The diagnosis is wide open, and we take no further action until we have the results of the various x-rays and so on. . . . Now, it is getting late, who do we see next? YOUNG DOCTOR (new to team): I think we can probably skip the next two cases, they are both terminal. There's really nothing anyone can do. The first is the 64-year-old man with widespread secondar...

Ward Round--a boy with multiple joint swellings.

He was a thin, rather despondent looking child with tender, boggy, non-erythematous but mildly warm swelling of both ankles (figure 1), knees (figure 2), elbows and wrists as well as several proximal interphalangeal (PIP) joints bilaterally (figure 3). All of these joints were tender and had a reduced range of movement, and he found it difficult and painful to walk. There was no rash or fever, ...