📌 Show Notes

Hypotension on the Ward — Sepsis, Cardiogenic, or Bleeding?

Hypotension is one of the most time-critical problems you’ll encounter on the ward — but the real danger is not the number.

It’s the cause behind it.

In this episode, we break down how to approach low blood pressure under pressure, using a simple, structured framework that helps you think clearly at 2am.

Hypotension is not the diagnosis — it’s the warning.

In this episode of AcuteCast, we break down one of the most time-critical presentations in acute medicine: low blood pressure on the ward.

Is it sepsis?Cardiogenic shock?Or internal bleeding?

Because treating hypotension without understanding the cause can make things worse — not better.

Through a realistic night-shift scenario, we explore:

• How to recognise shock early

• The key differences between hypovolaemic, septic, and cardiogenic patterns

• Why “just give fluids” can be dangerous

• The most common on-call cognitive traps

• A simple bounded-action framework you can use immediately on the ward

This episode is about thinking clearly under pressure — and making the right decision before the patient deteriorates.

🎯 Key takeaway:Don’t treat the number. Identify the shock. Treat the cause.

Show notes: Raised troponin without chest pain: don’t panic and don’t dismiss. Learn how trend + context + ECG guide admit vs observe vs discharge.Episode 10 — Raised Troponin Without Chest Pain · Admit, Observe, or Discharge?

Troponin doesn’t diagnose NSTEMI — it detects myocardial injury. Your job is to explain the injury safely.

In this episode, we tackle a common dilemma: raised troponin without chest pain. We break down how senior clinicians use trend, context, and ECG to avoid two extremes: treating everyone as ACS, or dismissing the result as “just a leak”.

You’ll learn:

• Why one troponin is a number, and two troponins are a direction

• Contexts that commonly raise troponin (and still carry risk)

• How to avoid overcalling ACS vs missing atypical or silent MI

• A bounded-action framework for disposition: admit, observe, or discharge

• How to document reasoning clearly under pressure

Educational content only — not a substitute for local guidelines or senior clinical advice. For troponin decision tools and admission thresholds, visit the AcuteCast app.

Show notes: Collapse feels chaotic — but physiology has an order. Learn how seniors stabilise first, then diagnose safely.Episode 9 — The Collapsing Patient

Collapse feels like chaos — and chaos makes clinicians freeze, scatter, or chase the wrong problem.

In this episode, we cover a collapse scenario and the key principle: collapse is not a diagnosis, it’s a physiology problem. We focus on structured assessment under pressure, rapid reversible causes, and recognising dangerous syncope patterns that aren’t safe for discharge.

You’ll learn:

• Why ABC is the only anchor when everything speeds up

• The fast reversible checks that prevent missed catastrophes

• When “vasovagal” is not a safe assumption

• High-risk syncope patterns that demand escalation

• The senior question: “what will kill them first?”

Educational content only — not a substitute for local guidelines or senior clinical advice. For collapse checklists and safe escalation frameworks, visit the AcuteCast app.