Advertisement

Care on the General Medical Ward

  • Alastair McKinlay
  • Rebecca McKay
Chapter

Abstract

  • When should we consider admission to a medical ward?

  • How do we assess physical risk in a patient with severe malnutrition?

  • What is the role of the medical unit in the management of the severely ill patient?

  • How can we safely manage the potentially fatal complication of refeeding syndrome?

  • When is nasogastric feeding required and how can it be conducted safely?

  • How can the patient’s anorexic behaviour be contained, to prevent or heal any splitting and low morale among staff?

  • What are the risks and problems of transition to further care?

Notes

Alastair McKinlay

is a Consultant Gastroenterologist at Aberdeen Royal Infirmary and the Eden Unit, with a special interest in nutrition and eating disorders.

Rebecca McKay is a Specialist Doctor in Gastroenterology, with an interest in nutrition and eating disorders, at Leeds Teaching Hospitals, NHS Trust, Leeds, UK.

References

  1. 1.
    Keys A, Brožek J, Henschel A, Mickelsen O, Taylor HL, et al., editors. The biology of human starvation. Minneapolis, MN: University of Minnesota Press; 1950.Google Scholar
  2. 2.
    MDcalc. Corrected QT interval. 2016. http://www.mdcalc.com/corrected-qt-interval-qtc/.
  3. 3.
    Sachs KV, Harnke BMLIS, Mehler PS, Krantz MJ. Cardiovascular complications of anorexia nervosa: a systematic review. Int J Eat Disord. 2016;49(3):238–48.  https://doi.org/10.1002/eat.22481. 0276-3478.CrossRefPubMedGoogle Scholar
  4. 4.
    The Royal Colleges of Psychiatrists, Physicians and Pathologists UK. MARSIPAN: management of really sick patients with anorexia nervosa, 2nd ed.; 2015. http://www.rcpsych.ac.uk/files/pdfversion/CR189.pdf.
  5. 5.
    National Institute for Health and Clinical Excellence (NICE). Nutrition support in adults. n.d. http://guidance.nice.org.uk/CG32.
  6. 6.
    Saudek CD, Felig P. The metabolic events of starvation. Am J Med. 1976;60(1):117–26. 0002-9343.CrossRefPubMedGoogle Scholar
  7. 7.
    Boateng AA, Sriram K, Meguid MM, Crook M. Refeeding syndrome: treatment considerations based on collective analysis of literature case reports. Nutrition. 2010;26(2):156–67.  https://doi.org/10.1016/j.nut.2009.11.017. 0899-9007.CrossRefPubMedGoogle Scholar
  8. 8.
    Norris ML, Harrison ME, Isserlin L, Robinson A, Feder S, Sampson M. Gastrointestinal complications associated with anorexia nervosa: a systematic review. Int J Eat Disord. 2016;49(3):216–37.CrossRefPubMedGoogle Scholar
  9. 9.
    Bouquegneau A, Dubois BE, Krzesinski J, Delanaye P. Anorexia nervosa and the kidney. Am J Kidney Dis. 2012;60(2):299–307.  https://doi.org/10.1053/j.ajkd.2012.03.019. 0272-6386.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Aberdeen Royal InfirmaryUniversity of AberdeenAberdeenUK
  2. 2.Leeds Teaching Hospitals NHS TrustLeedsUK

Personalised recommendations