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Jul 13, 2022 14 tweets 8 min read Read on X
How to keep cool and healthy in a heatwave. 🌞

Some key tips to share with your friends, family and patients.

Enjoy the thread🧵⤵️
1. Stop the heat getting in.

🪟 Close your doors and curtains/blinds. The sunlight brings the heat.

😎Shade is cooler so stop the sunlight and you will feel cooler.
2. Adjust your activity.

🕛Avoid being active in the middle of the day and reduce unnecessary movements, this will keep you cooler.

🏃🏿‍♂️If exercising then remember to hydrate more!
3. Hydrate sensibly

🥤Cool (not cold to look after your throat) fluids are best.

🍸Sip do not gulp as you pee more out.

❌Reduce/avoid caffeine or alcohol as you pee more out

🍉Watermelon, fruit and homemade ice lollies are great for kids
4. Understand your medications

💊You may need certain medications more or less in extreme heat

🫁 Heat may trigger asthma requiring more inhaler use

🚰 Some medications affect your kidneys so hydration is vital

❄️Some medications need to be kept cool like drops and liquids
5. Dress better

👕Cool, loose clothing. Cotton best, modesty as per situations.

🇨🇴Avoid dark colours they retain heat

👡Sensible shoes for the inevitable foot swelling
6. Avoid getting sunburn

🌲Slip - into the shade, avoid direct sunlight

🧴Slop - on plenty of sunscreen, ideally factor 30 or higher and before you put your clothes on

🧢Slap - on a cap, top or thin shawl to protect your skin in the sunlight

😎Wrap - your eyes with sunglasses
7. Manage sunburn easily

If you get sunburn:

🫧 Keep the area clean
💊It hurts, take pain relief regularly
❄️Use a cooling antiseptic cream
🛌🏿Rest, it will take a few days to get better

All done by self-care (rarely need to see a doctor)

More advice: nhs.uk/conditions/sun…
8. Keep cool

👩🏿‍🦳Wet hair is like your own air conditioning, try it.

🚿Have a cool shower, hot showers are not sensible so stop it

💦Wet flannel on the neck and back is an awesome cooling method

🦶🏿Feet in a water bucket is also amazing and effective
9. Sleep easier

🛌🏿Sleep with minimal clothes ideally naked and thin sheets. Don't waste money on fans/AC if using a duvet

😴Cotton sheets are better than manmade

🐕Sleep separately from partners/kids/pets if able. Body heat makes it hotter

⏲️Change automatic heating settings
10. extra tips

🤣Sleep on the floor. Heat rises, so it is cooler down there

🥗Eat small watery foods regularly rather than large meals

🧂Extra fibre and salt keep the bowels regular and replenish what you lose in sweat

🧊Refrigerate your bed sheets for a cool night
What tips have I missed that need to be shared?

Add them on here if you made it this far....

#Heatwave2022
11. Extra tips 2

👴🏿Check on your neighbours esp the elderly and the vulnerable, it will hit them harder

💊Your local pharmacy can help with hayfever which can be worse and most insect bites

🛞 Cover your steering wheel in fabric/ keep thin gloves so you don't burn your hands

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More from @drgandalf52

Apr 4
I (@CraigNikolic) often post about the NHS's "Same day" plans for in-hours general practice hubs being dangerous, and why ICBs are misusing them to fill an unfunded gap, I rarely take time to explain WHY. So, here we go

They forgot to ask what patients really need. 1/28
If you were to take the NHS of a quieter time, with low waits and no decade of year-on-year cuts to services downstream of general practice, it may be something to consider.

We're not there though, and austerity general practice patients need GPs, not quantity of appts. 2/28
Let's start with an example:

A patient needs a hip replacement. In a non-austerity system, the only time they'll see their GP is when the GP refers them as it'd be refer > outpatient appt > surgery > home with follow-up care. Patient freed of pain and gets on with life.

3/28
Read 29 tweets
Feb 6, 2023
PCN DES Thread time trail!

Over the next few days, I will explain the PCN DES in General Practice.

Buckle up for an education.... 1/x🧵 ⤵️
The PCN DES (Primary Care Network Direct Enhanced Service) is a funding program aimed at improving primary care services in England.

It was introduced in 2019 as part of the NHS Long-Term Plan, which outlines the government's vision for the future of the NHS. 2/x
The goal of the PCN DES is to support the development of Primary Care Networks (PCNs), which are groups of GP practices serving ideally populations of 30-50k people.

The aim of PCNs is to provide more integrated and comprehensive care for patients in their local communities. 3/x
Read 15 tweets
Oct 5, 2022
Hospital colleagues, community care, and wider.

Are you aware from 1st Nov most patients will have access to their GP records and see all communications & letters you send automatically?

Follow these 7 steps to make your's, the GP practice, and your patient's lives easier 🧵⤵️
1. Assume the patient can see everything you have written.

This should be the norm, and applicable if the patient had requested a subject access request (SAR) anyway.

This is good medical practice anyway.
2. Also do not assume the patient WILL see the letter

Although patients will have access automatically from 1st Nov, do not assume ALL patients will be checking their GP record for information. If you need to inform the patient of something contact them directly as well.
Read 10 tweets
Oct 4, 2022
Welcome to #GPTriageTuesday #5 will you choose wisely?

Three consultation types but only one of each to use and you must use each one:

✉️ Online (text/photo only)
📱 Phone/video
😷 F2F can be clinic or visit.

Justify your answers if you can...

Your cases are below🧵⤵️
1️⃣ 25y old ♀️ asking for the morning-after pill. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay.

2️⃣ 29y ♂️ asking for a nasal spray for hay fever. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay. 🧵⤵️
3️⃣ 35 ♂️ sprained wrist last week asking for ibuprofen for pain relief. Has specified doesn't want to go directly to the pharmacy as doesn't want to pay.

How will you choose to manage #GPTriageTuesday today #MedTwitter?

Share with your colleagues and see who does what..
Read 4 tweets
Jul 30, 2022
If you think seeing a GP is tough, unfortunately it is about to get so much worse...

Here is a thread why, and spoilers, it is going to be controversial as it goes along 🧵⤵️

1/x
Firstly, General Practice was in a difficult place before COVID happened and pivoted overnight to create remote access to keep patients safe.

It then delivered the majority of the national 'World beating' vaccination scheme. 2/x
There were definitely changes in access, much of it dictated by @NHSEngland and infection control policies which are still in practice still in some way, and vilified by certain parts of the media 3/x
Read 12 tweets
Jul 13, 2022
Who advances to the final of #GPBattle for the greatest fictional TV 'GP' of all time?

Will it be the resilient Dr Martin Ellingham from Doc Martin or the finesse of Dr Gemma Foster from Doctor Foster to face Dr Karl Kennedy in the final

Vote below by Thurs morning...
Vote for your finalist of #GPBattle for the greatest fictional TV 'GP' of all time?

Will it be the resilient Dr Martin Ellingham from Doc Martin or the finesse of Dr Gemma Foster from Doctor Foster?

You decide....

#medtwitter
Best comment so far...

'I learnt my bedside manner from Doc Martin and drinking habits from Doctor Foster …'
Read 4 tweets

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