The Desktop Consultation Dashboard
CLINICAL TOOLS A-F
- AF Stroke Risk: CHA2DS2
- Anti-coagulation: HAS-BLED score
- Alcohol: AUDIT
- Alcohol: CAGE
- Ambulance: types of responses & NEWS2 scoring
- Anxiety: GAD-7
- Back Pain – Keele SBST tool (predicting the risk of chronic back pain)
- Bereavement Reaction Assessment Tool
- Bereavement Risk Assessment Tool (BRAT)
- Bereavement Assessment – notes
- Carpal Tunnel Score (CTS)
- CENTOR sore throat score
- Dementia: 6CIT
- Demetia: Abbreviated Mental Test (AMT)
- Dementia: GPCOG
- Dementia: IQCODE (cognitive decline assessment based on information from carers)
- Depression: Geriatric Depression Scale (GDS)
- Depression: PHQ-9
- DVT: Well’s score
- Epworth Sleepiness Scale
CLINICAL TOOLS G-S
- Fever-Pain sore throat score
- Glasgow Coma Scale (GCS)
- HAS-BLED Score
- Hepatitis Serology Interpretation
- NEWS2 scoring (whether to admit a patient or not)
- Obstructive Sleep Apnoea Epworth Scale
- Opioid Conversion Diagram
- Opioid Conversion Table
- Orthopaedics: New Zealand joint replacement scoring
- Osteoporosis: FRAX tool
- Osteoporosis: QFracture Score
- PEFR Adult
- PEFR Child
- Phobias: IAPT Phobia Scale
- Pregnancy Due Date Calculator
- Pulmonary Embolism Well’s Score
- Postnatal Depression Scale (Edinburgh) – electronic
- Postnatal Depression Scale (Edinburgh) – paper
- Prostate Symptom Score (IPPS)
- Sleepiness Scale: Epworth
- Sore Throat: CENTOR score
- Sore Throat: FEVER-PAIN score
- Sore Throat: STARWAVe score for children/infants
CLINICAL TOOLS S-Z
- Spirometry Calculator
- Spirometry Interpretation
- STARWAVe sore throat score
- Steroids (inhaled) – equivalence doses (adult)
- Steroids (inhaled) – equivalence doses (Child)
- Suicidal Risk Assessment
- Suicidal Risk Asessment – TASR
- Renal Function: GFR estimate
- Renal Function: Stages of CKD
- Urgent Care: Ambulance response types
- Urgent Care: Glasgow Coma Scale (GCS)
- Urgent Care: NEWS2 calculator
- Urgent Care: NEWS2 info (National Early Warning Score)
- Weight: stones-kilos conversion at a glance chart
- Weight: stones-kilos conversion calculator
- Weight: BMI
- Weight: waist-to-hip ratio
- Well’s score for DVT
- Well’s score for PE
Know Your Vitals
OTHER VITAL SIGNS
WEIGHT ESTIMATION IN CHILDREN 1-10 years
WEIGHT ESTIMATION IN CHILDREN under age 1
Here are a highly selective list of websites that may help you during your consultations. You don’t have to remember any of these – this page should serve as your consultation tool box! Just like a plumber who has many tools in his box but only selects the right one for the right job, the GP needs to focus on those which will help with the particular task before them. Rather than provide you with an overwhelming list similar to the Yellow Pages, I’ve only included those that I find invaluable in my day to day practice. I hope you will find them helpful too. If you find anything you feel would be helpful to others, please email me here.
I use GP Notebook and NICE CKS. Then I only resort to the others if these two do not provide “the answer”.
- GP Notebook – I love this because it is straight forward and to the point. Needs registration but is free after that. Keeps a log of everything you have been reading up on during consultations (called Tracker) which can help with evidence of learning for your ePortfolio and especially the “Performance, Teaching & Learning” capability.
- NICE CKS – A simply amazing website which is constantly kept up to date. What I like about this one is that it provides information on what you might do in different clinical contexts.
- NHS Conditions – A to Z of conditions and accompanying advice.
- Medendium Guidelines – This link takes you straight to the wonderful flowcharts and protocols they have that will prove useful in the consultation. There are other educational modules too. (You can sign up to their free quarterly book where you find all the flowcharts in ONE place). Excellent for your desk.
- NICE pathways – everything NICE says on a topic in an interactive flowchart.
- SIGN guidelines – I see them as a Scottish version of NICE (although NICE are UK wide). Again, great diagramatical guidelines. If NICE doesn’t have one, look on Medendium Guidelines or on SIGN.
- BBC Health – good for looking up the latest about some hot clinical condition or research that is affecting the UK. So, if a patient says, “Doc, what do you think about xxx on the news then”, you now know where to look.
- Government Population Screening Programmes – a list of the current screening programmes on the NHS and details about each one
- BENEFITS & DWP – the government site which tries to explain things like benefits, fit notes, maternity certificates and so on. It has lots of good advice for the health professional. I’ve just seen an article that says “advising patients about work – an evidence based approach for GPs” – sounds good! Better go and read that myself!
- DermNetNZ.org – great collection of skin pics, for yourself and to show patients. Go to the “A-Z” section on the right hand side of the page and select a letter, then the condition and you’ll see some great pictures (good for explaining things to patients).
- Dermatology: PCDS – another dermatology website with great resources. And if you are interested in developing demoscopy skills, this is the place to go.
- ECG Library – amazing collection of ECGs.
- PALLIATIVE CARE: Scottish Palliative Care Guidelines – covers everything from symptom control, pain, palliative emergencies to End of Life care.
- VERSUSARTHRITIS – amazing patient information leaflets and video demonstrations of exercises to do to fix (say) their shoulder. You should know some of these exercises for the CSA.
- BNF Adults
- BNF Children
- MIMS – (I sometimes prefer MIMS to the BNF; need to register. If you don’t fancy this, then get the free book sent our quarterly – it’s good!)
- —–Other than the above, I don’t often use anything else, but sometimes find an interesting thing in one of the following —
- Leicester Medicines Strategy Group – great summaries about treatment algorithms like “Malnutrition in Adults” and “Amber/Black-listed Drugs”.
- BNF drug treatment summaries
- BNF drug interactions database
I stick to the first two and usually find 95% of my answers there. If not, I move down the list.
- Leeds Path Labs – individual tests – has comprehensive guidance on what to do with what result. Search for a blood result (e.g. Alk Phos) and then click the SECOND box for clinical information (not the first.)
- Leeds Path Labs – textbook of lab medicine – the website isn’t pretty but the information is good! Click on one of the tabs and then a secondary submenu e.g. Renal & Electrolytes > Hyponatraemia. Not sure how well maintained – as some of the reference resources seem a bit old.
- RCPA bloods manual – this is an Australian website by the Royal College of Pathologists. It’s a beautiful website where you can either look up a Clinical Problem (e.g. Anaemia) and see what you need to do or look up the blood result (e.g. Alk Phos) to see what the result means. Exceptional.
- ClinLab Navigator – really up-to-date American website. Tells you everything you could possibly want to know. Perhaps too much information. Some tests I found hard to find, perhaps they’re called something different in the US. I tried looking for anti-CCP but found it only by typing CCP into the search box.
- LabTestsOnline – although American and not UK, the clinical information isn’t going to be different. Perhaps need to be a bit careful when looking at the units of measurement. It’s a clean website written for patient BUT exceptional clinical information under the “Common Questions” section – like what causes a high or low result and what other tests might be needed.
- Blood Tests on Knowledge Dose – I quite like this site. Provides links to articles on common abnormal bloods like hyponatraemia, abnormal LFTs, anaemia, bloods in pregnancy and so on. It really is good although some articles out of date.
- The Full Blood Count in primary care (2008)
- Na & K abnormalities: a primary care approach (2011)
- Abnormal LFTs (2016)
- Thyroid disorders (2006)
- Thyroid again – UK guidelines (2006)
- Endocrinology Handbook (2018)
- Rheumatology Drugs & Bloods Manual – Yorkshire 2019
- Hepatitis Serology Interpretation
- Varicella Antibody interpretation in Pregnancy (Chicken Pox)
- PATIENT.INFO – Brilliant patient information leaflets. Type in the search box and then click a resource that says “CONDITIONS” which patient-tailored. The “PROFESSIONAL” items are for you as a doctor. Click their PRINT ICON (as opposed to File > Print Page) to print a resource so it prints nicely for the patient.
- DVLA at a glance
- VERSUS-ARTHRITIS: Exercises sheets for Joint Problems
- VERSUS ARTHRITIS video exercises – VersusArthtitis used to have loads of wonderful videos for each system like the neck, shoulder, knee, ankle and so on. I can’t find any of them except the one For Back Pain. If you manage to locate them, please email me with details [email protected]. I have found some on their YouTube page but at the moment, they seem to be very disorganised.
- HELPGUIDE.ORG – a great place to refer patients to for self-help material regarding mental health problems and stress. You should dip in yourself – you might find something that helps your own life, like relationships, self-esteem and so on. The more you use it, the better you can advise patients.
- NORTHUMBERLAND SELF-HELP BOOKLETS – these are amazing. Don’t just dish them out to patients. Read them. Get familiar with the content. Is great for CSA.
- LIVING LIFE TO THE FULL – another great website for patient (and yourself?). This is a powerful life skills resource written by a Psychiatrist using a Cognitive Behaviour Therapy (CBT) approach and also in helping people use these skills in everday life. You have to register, but it is a one-off process and FREE.
- EMBARASSING PROBLEMS – As the name suggest, embarassing problems like “a chronic anal itch” and you don’t know what to advise. If it’s an embarassing problem and you don’t know how to advise, try looking here first.
- DRUGS: Talk to Frank – Now, I’m one that is not so clued up on drugs and sometimes patients talk to you as if they expect you to know everything about the street drug that they take. Well, Talk to Frank is a great place for you and them! Also covers things like Cannibis oil.
- TRAVEL HEALTH ADVICE: FitForTravel – Click the Destinations section and search for the country your patient is travelling to. The website is provided by the NHS (Scotland). It gives travel health information for people travelling abroad from the UK. Dead easy to use and provides concise information that will not overwhelm you.
- NICE EVIDENCE – just type what you’re looking for and hit the search button. Make better, faster, evidence-based decisions. Searches authoritative evidence in health, social care and public health.
- PUBMED – I think PubMed was Al Gore’s legacy (for those who don’t know – an American politician and environmentalist). It really is a great site if you want to look for some quick evidence. It was designed for the public – so you can just type your query in a layman’s way.
- COCHRANE – one of the most reliable and trusted evidence based websites to help you make informed clinical decisions. It has been around for a long time and is well established. Always up to date! Just type something into the search box.
- BEST PRACTICE BY BMJ – provides a good clinical decision support tool for all health professionals, but requires a subscription cost!
- BESTBETS – a great site from emergency physicians at Manchester. Basically, they periodically summarise the latest evidence for things in a nutshell – so that you can find “the best evidence” when you need it the most. I typed “asthma” to find something steroids – were oral just as good as iv in acute asthma – and the answer was there on the top! Be careful though – look at the publication dates, some are quite old!
- BPAC-NZ: This is a New Zealand Best Pracitce site and although not UK based, I love it. All articles are colourful and easy to read and based around what the latest research and evidence says. Click the “By Category” tab for the best navigation.
- OPENATHENS – You can get free access if you approach your hospital’s librarian. Great for doing research and projects.
- GOOGLE SCHOLAR – Don’t forget Google Scholar – it searches only the reputable journals like NEJM, JAMA, Lance, BMJ etc.
- GoogleTranslate – Yes, I use Google Translate if I have an unexpected patient who walks in and speaks little English. The important thing is to turn the screen to them, and when you type in the English box, keep your sentences very simple and short to avoid errors through loss in translation. So, rather than saying “That looks to me like a cyst and it is absolutely nothing to worry about” you might write “That is a cyst and it is not dangerous”. Allow them to type back if they are able to. By the way, did you know you can hit the microphone button for both them and you to capture the words if they can’t type for instance. Try it.