UK immunisation schedule and links 2020

https://www.gov.uk/government/publications/the-complete-routine-immunisation-schedule
This is june 2020
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/899423/PHE_Complete_Immunisation_Schedule_Jun2020_05.pdf

https://patient.info/doctor/immunisation-schedule-uk

This table is  from patient.info

UK 2020 Immunisation Schedule
AGE	Immunisation (Vaccine Given)
8 weeks	DTaP/IPV(polio)/Hib/HepB (diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b and hepatitis B) - 6-in-one injection (Infanrix hexa®); plus: Rotavirus (Rotarix®) - oral route (drops). Meningitis B Bexsero®). PCV (pneumococcal conjugate vaccine) - in a separate injection (Prevenar 13®). Note - for children born from 1st January 2020, this vaccine is offered at 12 weeks and 1 year rather than at 8 weeks, 16 weeks and 1 year.
12 weeks	DTaP/IPV(polio)/Hib/HepB 6-in-one injection, 2nd dose (Infanrix hexa®); plus: PCV (pneumococcal conjugate vaccine) - in a separate injection (Prevenar 13®) for babies born after 1st January 2020. Note - for children born before 1st January 2020, this vaccine is offered at 8 weeks, 16 weeks and 1 year rather than at 12 weeks and 1 year. Rotavirus (Rotarix®) - oral route (drops).
16 weeks	DTaP/IPV(polio)/Hib/HepB 6-in-one injection, 3rd dose (Infanrix hexa®); plus: Meningitis B 2nd dose (Bexsero®). PCV (pneumococcal conjugate vaccine) - in a separate injection (Prevenar 13®). Note - for children born from 1st January 2020, this vaccine is offered at 12 weeks and 1 year rather than at 8 weeks, 16 weeks and 1 year.
Between 12 and 13 months	Hib/MenC (combined as one injection) - 4th dose of Hib and 1st dose of MenC (Menitorix®); plus: MMR (measles, mumps and rubella) - combined as one injection (Priorix® or M-M-RVAXPRO®); plus: PCV 2nd dose (Prevenar 13®) - in a separate injection. Meningitis B 3rd dose (Bexsero®).
2 years- end of primary school	Nasal flu spray annually (Fluenz Tetra®) for all children. For children aged 2, 3 and 4, this is usually given in the GP surgery. Children in primary school should have this at school.
3 years and four months	Preschool booster of DTaP/IPV(polio). 4-in-one injection (Repevax® or Boostrix IPV-IPV®); plus: MMR 2nd dose (Priorix® or M-M-RVAXPRO®) - in a separate injection.
12-13 years (boys and girls)	HPV (human papillomavirus types 16 and 18) - two injections (Gardasil®). The second injection is given 6-24 months after the first one.
14 years	Td/IPV(polio) booster. 3-in-one injection (Revaxis®). Men ACWY: combined protection against meningitis A, C, W and Y (Nimenrix® or Menveo®).
Adults	Influenza (annual) and PPV (pneumococcal polysaccharide vaccine): for those aged over 65 years and also those in high-risk groups. Td/IPV(polio): for those not fully immunised as a child or travelling to high-risk areas (Revaxis®). DTaP/IPV: for pregnant women from 20 weeks of gestation to protect the newborn baby against whooping cough or people travelling to high risk areas (Boostrix-IPV® or Repevax®).  Shingles (Zostavax®) vaccine: for adults aged 70 or 78 years. (Plus catch-up for adults born after 2nd September 1942 who have not previously been immunised if they are under 80 years).

GP and Human

I love this post, and really want to share it.

Could not have written it better.

She speaks of that moment, when we feel like we are trying to draw blood, from stone.
We're just trying our best. And we feel, like the enemy.

https://gpandhuman.com/2017/09/16/theotherside/

AKT & CSA: onwards we struggle, resources, links, revision tips, ideas, a place to put this stuff down in the hope this crappy exam we may sail through

AKT : and we struggle on, and we hope to reach the end, and we search for useful resources, and we put them where we can

This website, is really a gem from someone else who has worked hard to revise some of the more annoying things with respect to AKT in video format. Also other useful GP training related tips. The home page may be relevant for the medical students of you, and for the those who have qualified but need a refresher in mindmap fashion.

http://medimaps.co.uk/akt-revision-videos/  (for those doing AKT)
http://medimaps.co.uk/gp-trainee-resources/  (for GPs - a nice training resource)

http://medimaps.co.uk/about/  (all about the site)
http://medimaps.co.uk/  (for the medstudents)


Then, we have the famous BradfortVTS webpage
http://www.bradfordvts.co.uk/
http://www.bradfordvts.co.uk/online-video/
http://www.bradfordvts.co.uk/mrcgp/akt/  (this is basically the GOLDEN PAGE for more links eg to RCGP etc)

And finally:
http://www.rcgp.org.uk/training-exams/mrcgp-exams-overview/mrcgp-applied-knowledge-test-akt.aspx  [everything else you need to know about it from the horse's mouth, the RCGP]
AKT sample paper with answers
AKT April 2016 Feedback report

The rest of this page, or remainder of this blog may end up having a lot of AKT//CSA related stuff, as part of ongoing revision. Sadly, having failed this twice, I'm pulling my teeth out. Will let you know how things go, and what gems I discover along the way. Please share with me as you feel fit, because together our overall aim, I would hope, is to be better doctors for the benefit of all......

Update:  
I would highly recommend anyone in the UK to access the following -
Dr Nigel Giam's courses - I found personally very helpful, in particular regularly reviewing his videos, and the AKT and CSA courses I did with him. He is dedicated in  what he does and has seen so many students that he can  spot easily the weaknesses with advice to improve.
http://www.docgiam.com/   He is also on  facebook, and can be followed there.

I would also recommend the courses provided by Emedica.
https://www.emedica.co.uk/
There is an online AKT mock test one can try.
They also have a really good 'Life after CCT' course, comprehensive, and a booklet to go with it, useful work and costings.

And finally, if anyone is really struggling to find someone to practice with, I do know someone who has offered his time for a cost via Skype/video learning, in order to help those struggling - as we know, there are those in  some VTS groups where there are such a minimal number of trainees, perhaps one is an international medical graduate and there aren't many people in your peer group to practice with, or there aren't any people willing to give time or make time for you. Drop a comment and will see what we can do. However, I understand that in light of Covid - the exam format may have changed somewhat. Dr Giam has more on this.

There are also other groups of interest too, this eg AroraAman and BeejShah (medlighten)  I don't have personal experience of these but Beej has plenty of useful material on facebook.
https://aroramedicaleducation.co.uk/
https://www.facebook.com/medlighten/

psychiatry links

http://www.trickcyclists.co.uk/pocket_psychiatry.htm

http://psychskills.co.uk/

catheterisation - points i tend to miss

- explain why to do it
- wash hands
- maintain dignity as far as possible.
- double gloving
- not 'dropping the penis in to the sterile field'
- retracting foreskin before and after
- cleaning clockwise from centre out, each time, from twelve, from 3, from 6 from 9
- making sure the catch tray is there at the end of the catheter to catch the urine
- asking the patient if they feel pain at any point in time- especially at point of distending the balloon to hold in bladder trigone area...cos if ur blowing it up in the middle of the urethra u'll end up with trouble and major pain - do not want that!!

-Note size of catheter and volume of water used for ballooning to document in notes.
- making sure that you wait for 2-3 mins for anaesthetic to work, some say hold tip closed/massage down, but im not sure how to do that effectively

- clean sterile trolly down maintain clean area with alcohol, then open up pack so not touching inner sterile area. Drop everything in inner sterile area.

- make sure that the sterile solution is in the sterile bit filled already by yourself

- tear up the main bit of paper for passing over the penis area..clear field

- clearing everything away
- waiting for 3-4 mins while bag fills, chekcing urine for discolouration, blood, general appearance, and remember to put bag on the end of the tube.

-document in the notes : date, size of catheter, patient name, amount of water used for blowing up balloon, for colour and appearance of urine, any probs etc. sign ur name.

Obs and Gynae pocket doctor template

this is the gynae history from the POCKET DOCTOR booklet:

INTRO

CHECK
Patient name and age

PRESENTING COMPLAINT

HISTORY OF PRESENTING COMPLAINT

1. BLEEDING
menarche
period regularity
heavy? if yes: pad changing per day/flooding/clots/tiredness
LMP
IMB/PCB/PMB
Discharge: if yes: colour, smell

2. FERTILITY
Sexual contacts
STI's
contraception: barrier and birth control
HRT if post-menopause
Pregnancy attempts
Smears: last date and result
Breast screening

3. PAIN
Painful periods? at what part of cycle
Painful sex? On penetration/during

4. UROGYNAE
Prolapse: dragging sensation/something 'coming down'. Back pain.
Urinary: incontinence? relation to coughing/sneezing/straining
Urinary symptoms: freq, noct, dysuria, strangury, hameaturia, unable to interrupt stream.
Bowel habits: esp change in habits.

OBSTETRIC HISTORY
Pregnancies: date delivered, mode, weight, problems.
Miscarriages: gestation?
Termination: gestation, reason?
ectopics

PAST MEDICAL HISTORY
esp gynae operations

DRUG HISTORY

FAMILY HISTORY

SOCIAL HISTORY

summary
address pesky concerns

[Kindly written up by a friend]

'Explanations' Template for OSCE's or in life.

A friend of mine said:

real simple template:
egs are for endoscopy

1. WHAT it is and WHY we do it (camera test to look for ulcers/bleeding)
2. HOW we do it (spray at back of throat, thin camera tube in mouth)
3. SIDE effects and RISKS (sore throat and infection/perforation)
4. RESULTS: when and how you get them
5. PREPARATION and AFTER the procedure (eg starve 6hrs before endoscopy, have a lift home organised)

its quite basic, but covers most things!

In essence its, why what how, side effects, risks, complications, results, preparation, afterwards [immediate, short term, longterm]