Acute medicine
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Proximal muscle weakness can present acutely or subacutely to the Acute Medical Unit. Early diagnosis of the underlying pathology is essential due to life threatening complications such as respiratory failure and cardiac disturbances as well as causing significant levels of disability. ⋯ Assessment of respiratory function should be done promptly to identify patients with associated respiratory muscle weakness and treatment should not be delayed waiting for definitive and confirmatory investigations. Poor response to treatment is unusual when diagnosis is correct; this raises the possibility of an alternative diagnosis.
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Following an emergency medical admission, patients may be admitted an acute medical assessment unit (AMAU) or directly into a ward. An AMAU provides a structured environment for their initial assessment and treatment. ⋯ Patients, with equivalent mortality risk, allocated initially to AMAU or a more traditional ward, appeared to have substantially different outcomes.
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it is not known how best to respond to changes in the National Early Warning Score (NEWS) after hospital admission. This report manipulates and extrapolates previously published data on the trajectories of the abbreviated early warning score (AbEWS i.e. NEWS that does not include mental status). ⋯ the trajectories of early warning scores after admission are of prognostic importance, and escalation protocols should relate changes in the score to its initial value on admission.