Acute medicine
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A 65 year old woman presented to the Emergency Department of our district general hospital three hours following ingestion of a blended mixture of apples and foxglove leaves, mistaking them for spinach leaves. She complained of nausea, vomiting, abdominal cramps, dizziness and blurred vision.
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Numerous studies have demonstrated the value of echocardiography in the assessment of critically ill patients in the Intensive Care Unit (ICU) and Emergency Room (ER). We seek to encourage expansion of echocardiography in these areas. However it is important to establish training programmes, standards of knowledge and skills, assessment methods and quality assurance if echocardiography is to be offered with confidence in these clinical areas. We have undertaken discussion with the many groups with a relevant interest in critical echocardiography and developed a consensus on proposals for the appropriate provision of training in echocardiography for the ICU, ER, and increasingly the medical high dependency and admissions wards.