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  • Podcast - The Iron Overload Mystery: Why Ferritin Is Lying to You

    Podcast - The Iron Overload Mystery: Why Ferritin Is Lying to You
    2025/06/04
    The video version of this podcast can be found here: · https://youtu.be/qNboajtlrrsThis channel may make reference to guidelines produced by the British Society for Haematology. The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by them.My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the guideline by the British Society for Haematology on the investigation and management of a raised serum ferritin, focusing on what is relevant in Primary Care only. In the last two episodes I covered the guideline on iron deficiency and functional iron deficiency. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the guideline by the British Society for Haematology on the investigation and management of a raised serum ferritin can be found here:· https://doi.org/10.1111/bjh.15166The link for the British Society for Haematology website can be found here· https://b-s-h.org.uk/Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the guideline by the British Society for Haematology on the investigation and management of a raised serum ferritin, focusing on what is relevant in Primary Care only. A link to it is in the episode description.If you haven’t already, I recommend that you check out the last two episodes where we covered the laboratory diagnosis of both iron deficiency and functional iron deficiencyRight, let’s jump into it.Serum ferritin level is one of the most commonly requested investigations in both primary and secondary care. Whilst low serum ferritin levels invariably indicate reduced iron stores, raised serum ferritin levels can be due to multiple different causes, including iron overload, inflammation, liver or renal disease, malignancy, and metabolic syndrome. Reduced ferritin levels are only found in patients with reduced body iron stores. However, in some circumstances, for example in patients with co-existent inflammatory disorders, ferritin may be within the normal or elevated range even when iron stores are reduced and anaemia is due to iron deficiency. On the other hand, the clinical and laboratory management of patients with raised ferritin values is not that well recognised and this is why we are covering it here.Levels in serum can be raised because of inflammation, tissue damage as well as by any condition or treatment that leads to a genuine increase in iron stores (e.g. blood transfusion or iron infusion).Most UK path labs simply report 300–400 μg/l as the upper limit of normal for ferritin in adult males and 150–200 μg/l as the upper limit of normal for adult females. There is however considerable variation in response to age, ethnic origin and sex. Mean ferritin values in neonates are high (around 200 μg/l) and remain so for about 2 months. Mean ferritin values are higher at all ages in adult black males. In black females,...
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    12 分
  • Podcast - The Great Iron Heist: Understanding Functional Iron Deficiency

    Podcast - The Great Iron Heist: Understanding Functional Iron Deficiency
    2025/05/28
    The video version of this podcast can be found here: · https://youtu.be/Ugo6U9QI2xYThis channel may make reference to guidelines produced by the British Society for Haematology. The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by them.My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the guideline by the British Society for Haematology on the laboratory diagnosis of functional iron deficiency, focusing on what is relevant in Primary Care only. In the last episode I covered:· The guideline by the British Society for Haematology on the laboratory diagnosis of iron deficiency In the next episode, I will cover:· The assessment of raised ferritin I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the new guideline by the British Society for Haematology on the laboratory diagnosis of functional iron deficiency can be found here:· https://onlinelibrary.wiley.com/doi/10.1111/bjh.12311The link for the British Society for Haematology website can be found here· https://b-s-h.org.uk/Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the guideline by the British Society for Haematology on the laboratory diagnosis of functional iron deficiency, focusing on what is relevant in Primary Care only. A link to it is in the episode description.If you haven’t already, I recommend that you check out the last episode where I covered the laboratory diagnosis of iron deficiency And in the next episode, I will cover the assessment of raised ferritin. So, stay tuned for that!Right, let’s jump into it.Whilst the concept of functional iron deficiency—or FID—is both important and very relevant to us in Primary Care, reading the full guideline can be overwhelming. It’s full of detailed considerations more relevant to specialists and secondary care. So, instead of summarising that in its entirety, I’m just going to give you a general overview. I’ll take you through the relevant investigations, explaining each one in plain terms, and linking it back to what we need to know and do in general practice.And first of all, what is Functional Iron Deficiency (FID)?Functional Iron Deficiency happens when the body has enough iron stored, but can’t get it to where it’s needed — particularly, the bone marrow where red blood cells are made. This is different from true iron deficiency, but the effect is similar: not enough haemoglobin is made, leading to anaemia.Why Does This Happen?FID is common in long-term illnesses, like:Chronic inflammation (e.g. rheumatoid arthritis)InfectionsCancer andChronic kidney disease (CKD)In these situations:The liver produces hepcidin, a hormone that blocks iron release from stores and reduces absorption from the gut.So, even if ferritin looks normal or high, the bone marrow can’t access the iron, so red cell ...
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    9 分
  • Podcast - Testing for Iron Deficiency: Ironing Out the Details

    Podcast - Testing for Iron Deficiency: Ironing Out the Details
    2025/05/21
    The video version of this podcast can be found here: · https://youtu.be/ZdHSs-QBtacThis channel may make reference to guidelines produced by the British Society for Haematology. The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by them.My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the guideline by the British Society for Haematology on the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children, focusing on what is relevant in Primary Care only. In the coming episodes, I will also cover the recommendations by the British Society for haematology on:· The assessment of raised ferritin· The concept of functional iron deficiency I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the new guideline by the British Society for Haematology on the laboratory diagnosis of iron deficiency can be found here:· https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.17900 The link for the British Society for Haematology website can be found here· https://b-s-h.org.uk/Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the guideline by the British Society for Haematology on the laboratory diagnosis of iron deficiency, focusing on what is relevant in Primary Care only. In the coming episodes, I will also cover their recommendations on:· The assessment of raised ferritin· The concept of functional iron deficiency So, stay tuned for those!Right, let’s jump into it.The British Society for Haematology produces Good Practice Papers to recommend good practice in areas where there is limited evidence but where a degree of consensus is likely to be beneficial to patient care.The laboratory diagnosis of iron deficiency is difficult, because iron homeostasis is dynamic and no single test can provide an accurate assessment of iron absorption, transport, storage, and utilisation.Iron metabolism in adults and children can be considered equivalent, and these recommendations are applicable to both paediatric and adult practice, but it does not include pregnancy.Let’s start by saying that iron deficiency is the most common cause of anaemia worldwide. In the UK, the prevalence of iron deficiency anaemia can go up to 6% depending on age and sex, with higher rates in certain groups like menstruating women and those aged over 85 years.The prevalence of iron deficiency without anaemia, however, is not well documented.In this episode we are just focusing on the laboratory assessment of iron status and not the full guidance on iron deficiency anaemia which requires a detailed history, clinical examination and the review of, for example, national gastrointestinal and gynaecology guidelines as well as other local pathways.The British Society for Haematology has suggested an algorithm for the laboratory ...
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    11 分
  • Podcast - NICE News - April 2025

    Podcast - NICE News - April 2025
    2025/05/14
    The video version of this podcast can be found here: · https://youtu.be/aB6Z7tASKrcThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through new and updated recommendations published in April 2025 by the National Institute for Health and Care Excellence (NICE), focusing on those that are relevant to Primary Care only. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The Full NICE News bulletin for April 2025 can be found here: · https://www.nice.org.uk/guidance/published?from=2025-04-01&to=2025-04-30&ndt=Guidance&ndt=Quality+standard The links to the guidance covered in this episode can be found here: The NICE guideline on Falls: assessment and prevention in older people and in people 50 and over at higher risk [NG249] can be found here: · https://www.nice.org.uk/guidance/ng249 The update on Suspected cancer: recognition and referral [NG12] can be found here: · https://www.nice.org.uk/guidance/ng12· https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#myeloma TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome! I’m Fernando, a GP in the UK. In today’s episode, we’ll be looking at the NICE updates published in April 2025, focusing on what is relevant to Primary Care only.We’ve got another short and snappy episode today, as there are only two clinical areas to discuss: the brand-new national guideline on fall prevention and new advice on cancer recognition and early detection.Right, let’s jump into it.And let us start with the update on the cancer recognition guideline, which affects the recommendations on blood tests for myeloma. These recommendations have been amended in response to a series of reviews to improve earlier diagnosis. So now those with an unexplained fracture or persistent bone pain, particularly back pain, and especially if they are aged 60 or over, should be investigated for myeloma, although we can consider it for people under 60 too. For this assessment we will request the following blood tests:a full blood count serum calciumeither plasma viscosity or ESRparaprotein, using serum protein electrophoresis andSerum free light chains. If the serum test is not available, we can use a Bence–Jones test to check for free light chains in the urine. The change means that we should now include serum protein electrophoresis and serum free light chain testing in the initial diagnostic blood tests and this testing should be offered instead of the traditional urine test for Bence–Jones protein. The second section refers to...
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    7 分
  • Podcast - Wheat's the problem? A guide to the NICE guideline on Coeliac disease

    Podcast - Wheat's the problem? A guide to the NICE guideline on Coeliac disease
    2025/05/07
    The video version of this podcast can be found here: · https://youtu.be/474v7gUrz38This channel may make reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the new NICE guideline on coeliac disease: assessment and management, NG20, focusing on what is relevant in Primary Care only. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the NICE guideline on coeliac disease can be found here:· https://www.nice.org.uk/guidance/ng20/chapter/recommendationsDisclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido. TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the new NICE guideline on coeliac disease: assessment and management, or NG20, focusing on what is relevant in Primary Care only. Right, let’s jump into it.And before we start on the guideline itself, what is coeliac disease exactly?Coeliac disease is a genetic, immune-mediated enteropathy triggered by gluten in some people. It primarily affects the small intestine, leading to villous atrophy, crypt hyperplasia, and malabsorption.Why does it happen? Well, the pathophysiology is as follows:Gluten (specifically gliadin) is found in wheat, barley, and rye. An enzyme called tissue transglutaminase (tTG) modifies gluten peptides. In genetically predisposed people, these modified peptides are presented to T-cells, triggering an inappropriate immune response. This leads to inflammation and damage to the small intestinal mucosa, particularly in the proximal small bowel.We should suspect coeliac disease and offer serological testing if there is:persistent unexplained abdominal or gastrointestinal symptomsfatigue or weight lossmouth ulcersunexplained iron, vitamin B12 or folate deficiencyfirst‑degree relatives affected.conditions such as type 1 diabetes, autoimmune thyroid disease, and irritable bowel syndrome (in adults) and we should also consider testing in a number of other conditions, for example:· reduced bone mineral density, · unexplained neurological symptoms (like peripheral neuropathy or ataxia)· persistently raised liver enzymes and· Down's and Turner syndromesHowever, before arranging any investigations we will need to explain that any test is accurate only if a gluten‑containing diet is eaten during the entire diagnostic process. This also means that they should not start a gluten‑free diet until diagnosis is confirmed by a specialist, even if the results of a serological test are positive.Additionally, people following a normal diet should be advised to eat some gluten in more than 1 meal every day for at least 6 weeks before testing.If they have already restricted their gluten intake and they are unable to ...
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    7 分
  • Podcast - When breathing fails: Hard lessons from asthma deaths

    Podcast - When breathing fails: Hard lessons from asthma deaths
    2025/04/30
    The video version of this podcast can be found here: · https://youtu.be/JP5EvxGd8g4This channel may make reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the new NICE guideline on acute asthma, NG244, focusing on what is relevant in Primary Care only. Given how extensive the guidance is, in this episode I will just focus on lessons from asthma deaths and near-fatal asthma as well as reviewing the concept of difficult asthma. In the last four episodes I covered the initial assessment and treatment in both adults and children. Just like the NICE guideline on the management of chronic asthma, which was updated in November 2024, the NICE guideline on acute asthma is also a collaborative initiative developed by NICE, the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN). It replaces previous guidance, and you can find a link to it in the episode description.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the new NICE guideline on acute asthma can be found here:· https://www.nice.org.uk/guidance/ng244/chapter/Managing-acute-asthmaBased on recommendations on managing acute asthma in the BTS/SIGN British guideline on the management of asthma:· https://rightdecisions.scot.nhs.uk/bts-nice-and-sign-asthma-pathway/managing-acute-asthma/Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the new NICE guideline on acute asthma, or NG244, focusing on what is relevant in Primary Care only. Just like in chronic asthma, the NICE guideline on acute asthma is a joint effort by NICE, BTS and SIGN and a link to it is in the episode description.In this episode I will just focus on lessons from asthma deaths and the concept of difficult asthma. In the last four episodes I covered the initial assessment and treatment in both adults and children and, if you have not already, I recommend that you check them out.Right, let’s jump into it.Confidential inquiries into over 200 asthma deaths in the UK have identified that most asthma deaths occurred before the patient reached hospital and that there are three main contributing factors: the disease itself, medical management, and patient behaviour or psychosocial issues..And let’s start by looking at Disease Factors: Although, In a minority the fatal attack occurred suddenly in a patient with mild or moderately severe asthma, the majority of patients who died from asthma had chronically severe disease. In terms of Medical Management: Many deaths were linked to inadequate treatment with inhaled corticosteroids (ICS) or oral steroids, as well as poor monitoring of asthma severity. Follow-up ...
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    9 分
  • Podcast - Don't hold your breath: Treating acute asthma in kids

    Podcast - Don't hold your breath: Treating acute asthma in kids
    2025/04/23
    The video version of this podcast can be found here: · https://youtu.be/LxlmAeHzjsgThis channel may make reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the new NICE guideline on acute asthma, NG244, focusing on what is relevant in Primary Care only. Given how extensive the guidance is, in this episode I will just focus on the treatment of acute asthma in children. In the last three episodes I covered the initial assessment in adults and children and the treatment in adults and in the next episode, I will cover:· Lessons from asthma deaths and near-fatal asthma as well as reviewing the concept of difficult asthmaJust like the NICE guideline on the management of chronic asthma, which was updated in November 2024, the NICE guideline on acute asthma is also a collaborative initiative developed by NICE, the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN). It replaces previous guidance, and you can find a link to it in the episode description.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here:Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the new NICE guideline on acute asthma can be found here:· https://www.nice.org.uk/guidance/ng244/chapter/Managing-acute-asthmaBased on recommendations on managing acute asthma in the BTS/SIGN British guideline on the management of asthma:· https://rightdecisions.scot.nhs.uk/bts-nice-and-sign-asthma-pathway/managing-acute-asthma/Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the new NICE guideline on acute asthma, or NG244, focusing on what is relevant in Primary Care only. Just like in chronic asthma, the NICE guideline on acute asthma is a joint effort by NICE, BTS and SIGN. A link to it is in the episode description.In this episode we will just focus on the treatment of acute asthma in children.In the last three episodes we have covered the initial assessment in adults and children and the treatment in adults and in the next episode, I will cover lessons from asthma deaths. So, stay tuned for that!Right, let’s jump into it.When managing acute asthma in children, it helps to follow a structured approach to ensure effective and timely treatment. And let’s start by looking at the various therapeutic interventions, starting withOxygen: For children with life threatening asthma or oxygen saturation below 94%, we should immediately administer high-flow oxygen using a tight-fitting face mask or nasal cannula to maintain saturations between 94 and 98%.The next step is Inhaled short-acting β2 agonists: They are the first-line treatment for acute asthma in children. We need to bear in mind that when children require ...
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    11 分
  • Podcast - Little lungs, big wheeze: Assessing acute asthma in kids

    Podcast - Little lungs, big wheeze: Assessing acute asthma in kids
    2025/04/16
    The video version of this podcast can be found here: · https://youtu.be/FkZmvfQVby8This channel may make reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the new NICE guideline on acute asthma, NG244, focusing on what is relevant in Primary Care only. Given how extensive the guidance is, in this episode I will just focus on the initial assessment of acute asthma in children. In the last two episodes I covered the initial assessment and treatment in adults and in the next two episodes, I will cover:· Treatment of acute asthma in children· And finally, lessons from asthma deaths and near-fatal asthma as well as reviewing the concept of difficult asthma Just like the NICE guideline on the management of chronic asthma, which was updated in November 2024, the NICE guideline on acute asthma is also a collaborative initiative developed by NICE, the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN). It replaces previous guidance, and you can find a link to it in the episode description.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the new NICE guideline on acute asthma can be found here:· https://www.nice.org.uk/guidance/ng244/chapter/Managing-acute-asthmaBased on recommendations on managing acute asthma in the BTS/SIGN British guideline on the management of asthma:· https://rightdecisions.scot.nhs.uk/bts-nice-and-sign-asthma-pathway/managing-acute-asthma/ Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the new NICE guideline on acute asthma, or NG244, focusing on what is relevant in Primary Care only. Just like in chronic asthma, the NICE guideline on acute asthma is a joint effort by NICE, BTS and SIGN. A link to it is in the episode description.In this episode I will just focus on the initial assessment of acute asthma in children. In the last two episodes I covered the initial assessment and treatment in adults and in the next two episodes, I will cover the treatment of acute asthma in children and lessons from asthma deaths. So, stay tuned for those!Right, let’s jump into it.Acute asthma in children, particularly in those under five, can be challenging to assess.In this age group, intermittent wheezing attacks are often triggered by viral infections, and the response to asthma medications can be inconsistent. Children born prematurely or with low birth weight are at higher risk of recurrent wheezing episodes.We should also consider other potential diagnoses, which may include:Aspiration pneumonitis,Pneumonia,Bronchiolitis,Tracheomalacia,Or complications from underlying conditions, ...
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