GP case studies - involving virtual consultation

In our first digital technology webinar, Dr Mallicka Chakrabarty discusses a number of case studies from her clinical practice and how these scenarios were addressed using virtual consultation.

Patient 'A' is 90 years old. He has dementia and prostate cancer, for which he is under clinical surveillance for only.

He lives in a care home. Three weeks back 'A' had an unwitnessed fall, which led to a fracture in his pelvic bone. He needed hospital admission and had COVID-19 while an inpatient. The community physiotherapist was concerned about his pain and slow process, hence wanted a GP to review him.

A video consultation allowed an examination and discussion with Patient 'A' and his carers. His left leg was shorted and did not have any active movement and had pain on passive movement. He agreed to have a further x-ray which showed extension to his fracture.

Patient 'B' is 58 years old, she had been diagnosed with metastatic breast cancer in Feb 2020 and was undergoing palliative chemotherapy.

The patient had a recent hospital admission with AKI and while in hospital had COVID-19. She developed difficulty in breathing after discharge. While she was shielding initially, she and her family needed to be isolated.

To assess her symptoms drop-off pulse oximeter was arranged. Using this along with her own thermometer and BP enabled monitoring. A video consultation with the GP was reassuring and allowed a chance to discuss her symptoms and concerns.

Patient 'C' is 73 years old. He has vascular dementia and lives in a care home.

The ambulance crew were called as he had a temperature of 39 degrees. All other parameters were stable except for a shin wound that looked infected.

A GP visit was requested. Video consultation was carried out with care home staff and the ambulance crew. This allowed examination of the shin wound and a joint decision to be made, to manage him at the care home with oral antibiotics and a review the following week.