Update the medical & GP details held on your Hall files

I hope you have had a chance now to register with a GP (doctor) in the local area. If you have, please update the records we hold on your medical details form: call into the office behind reception during working hours, or email details of your new GP to info.connaught@london.ac.uk.

Now that you've moved in and got to know us a little, you might also feel more comfortable disclosing medical conditions to us. Again, you can do this in person or via email.

If it's easier for you, you can also just re-send us a completed, updated medical details form.

Medical details form: https://drive.google.com/open?id=0B8aHo3-r-MQLR2Z5QkhXWTlPaUE

If we hold accurate, up-to-date medical details about you, we'll be better able to help you in an emergency.

If you are unwell

As the 'flu season approaches, and coughs & colds become more common, here are some reminders about how to get help if you're unwell.


FIRST AID

If you need a first aider in Hall (or help of any kind), always ask at reception; don't rely on text messages, emails, or knocking on a first aider's door. There is always someone on duty in the Hall, 24 hours every day, and reception will be able to contact the right person for you.

First aiders in Hall: https://drive.google.com/open?id=0B8aHo3-r-MQLa1o4YWxiVUQ5d2s

URGENT HEALTHCARE

We have a poster outlining how to get urgent medical care in London using the National Health Service. The best first point of contact for health advice is NHS 111 (just call 111 from any telephone) or the NHS website: https://www.nhs.uk/symptom-checker/.

Urgent healthcare in London: https://drive.google.com/open?id=0B8aHo3-r-MQLXzZjb3pYd0ZrU2M

MENINGITIS

First-year university students are a high risk group for contracting meningitis ? a serious infectious disease. Be aware of the symptoms and signs of meningitis, and seek urgent medical help if you?re worried.

Meningitis symptoms & signs: https://drive.google.com/open?id=0B8aHo3-r-MQLT3ktcGE2RnAteWc

YES, I'M A DOCTOR

But I cannot offer medical consultations in hall to residents. This post explains why - http://connaughthall.blogspot.co.uk/2013/12/medical-problems-in-hall.html.

Medical problems in Hall

As many of you know, in addition to being your Warden at Connaught Hall, I am an accident & emergency doctor at University College Hospital. This often leads to residents asking me for medical advice, diagnosis, or treatment here in Hall.

With two small exceptions, I do not provide a medical service for Connaught Hall residents.

It can perhaps be a bit confusing or disappointing for residents when I say I cannot help with their medical problems ("But, you are a doctor, aren't you?"). So I hope this blog post will help explain why in most cases I am unable to diagnose or treat medical problems in Hall.

First, those two exceptions:

1. I can help with minor first aid problems like bruises, cuts, and burns in the same way that a first-aid trained layperson can.

2. I will provide an enhanced level of care -- as a doctor -- in immediately life-threatening situations such as a very severe allergic reaction (anaphylaxis).

I will not, however, take a proper medical history, perform a physical examination, take any tests, nor prescribe any drugs in my capacity as your Warden. I will be just as likely as any of the Senior Members to advise that you see your GP or attend hospital for proper medical attention.

This is why:

1. The University of London does not insure me to provide medical services. That means that if I make a mistake and you suffer harm as a result, you would not be able to claim compensation from an insurance policy - you could only claim against me personally, which unfortunately will not get you very much compensation!

2. A doctor cannot -- in most cases -- reach a safe, accurate diagnosis without performing a physical examination. But for me to do that would normally step over the line of acceptable physical contact between a Warden and a student resident. The University would not support me in doing that.

3. Furthermore, when I see patients in my hospital job, I have access to tests and diagnostic measures such as X-rays, ECGs,  and blood tests. It would be wrong for me to try and "guess" what is wrong with you without these tests.

4. In many cases when a doctor examines a patient, we will have a chaperone present for the protection of both the patient and the doctor. I do not have access to a chaperone in Hall.

5. Your GP has the benefit of access to your previous medical notes, which can be vitally important in making a correct diagnosis or deciding on the correct treatment plan. I do not have access to your medical history.

6. When you consult a doctor in hospital or a GP surgery, details of what happened will be recorded for future reference on your medical file. I cannot make entries in your medical notes from the Hall.

7. The General Medical Council requires that doctors in the UK must always keep contemporaneous medical records on every patient encounter, and communicate what happened in every encounter to the patient's primary care provider (usually their GP). I do not have the resources to do that in Hall, so I would be at risk of breaking my profession's rules of conduct.

Having said all of that, one last thing I can sometimes help with is in providing very broad, general advice about drugs you might have been prescribed by your doctor (i.e. how they work, how long it might take to get better, etc) or -- again -- broad and general information about medical conditions. But I must stress that I cannot provide private medical consultations in Hall.

No new cases of D&V this weekend

There have been no new cases of D&V reported in Hall since Thursday evening (more than 48 hours ago). Well done everyone and thank you for helping to contain the virus.

Toilet restrictions lifted

We now have microbiological confirmation that our outbreak of diarrhoea & vomiting was caused by Norovirus. This is extremely unlikely to have originated from the kitchen, but the catering investigation will continue, so if you were affected by this outbreak, please return a "food poisoning allegation" form to the Bursar's Office as soon as you can.

There have been no new cases today.

We have removed the signs designating toilets for affected and unaffected people. All the communal toilets are now back to normal. The hand sanitisers will remain in place until further notice. Please continue to practice rigourous hand hygiene, until we get the all clear from the health agency.

If you or anyone has diarrhoea or vomiting symptoms then please contact the Senior Member on duty over the weekend or email: sicknessreporting@connaught-hall.org.uk.

If the toilets or bathroom areas become soiled / blocked with sick or diarrhoea then please report this immediately to reception and they will contact maintenance to clean any soiled areas.

Laundry: wash your bed sheets and clothes on the hottest temperature the fabric can take. Use the "whites" or "hot" feature on the washing machine; this should be up to 60 degrees - but make sure your clothes can be safely washed at this temperature first. Contact the Bursar's Office if you have any visibly soiled bed linen.

We all hope everyone who was affected is now feeling much better.

Update on outbreak of diarrhoeal illness

In the last 24 hours, we have received 8 new notifications from residents who are unwell. At least two of those are probably unrelated to the outbreak. This compares with 31 new notifications in the first 48 hours of the outbreak. So it looks as though things are starting to settle down.

Regular handwashing with soap & water, especially after using the toilet, before eating, and after spending time with anyone who has been unwell, is still very important. The alcohol gel is a useful additional measure but does not replace hand washing with soap & water.

It's also really important that if you have been unwell, you must continue to use the "pink" bathrooms for 48 hours after your symptoms resolved, and be absolutely scrupulous about hand hygiene. Where possible, try to avoid social contact for 48 hours.

We are still waiting for microbiological data about the cause of this illness.

I think we are all very grateful to Dr Mark Hunter, the GP from 20 Gower Street, who spent around 3 hours in the Hall on Tuesday seeing unwell residents, and has been back another 3 times since. I will write to Dr Hunter to express our thanks and invite him to the University's big Diamond Jubilee party on 2nd June.

A common question arising now is about mitigating circumstances claims for missed exams, or exams where residents feel their performance will be impaired by having been unwell. The advice I give is as follows:

Ask your tutors what the procedure is at your particular institution for making an extenuating/mitigating circumstances claim. In most cases (and certainly if you actually miss your exam) they will expect a formal medical certificate from a doctor who has examined you. In this case, you should seek an appointment with your London GP (general practitioner / primary care physician / family doctor) as soon as possible.

I can provide a letter along the following lines, but it will be supplementary evidence only - not enough on its own to support a claim:

This person is a resident student at Connaught Hall. There has been an outbreak of diarrhoea and vomiting in the Hall, affecting a very significant proportion of our residents.

The likely causative organism of this outbreak is Norovirus, a very highly infectious virus sometimes called the “winter vomiting bug”. The Health Protection Agency (HPA) and local GPs are involved. Affected residents are being encouraged to isolate themselves for 48 hours after the last episode of diarrhoea, but the HPA recognises that this may not be possible during the exam season.

Please take these considerations into account with regard to any attendance logs, course work, or examinations expected of residents at Connaught Hall this week and next. Due to the timing, inability of those affected to leave the building – both due to isolation and the need to be close to a toilet - and the large numbers affected, they may not all be able to obtain a medical certificate from their doctor as quickly as we should like.

If you are going to see your GP, this text might be useful to show them.

I hope everyone affected is back to full health very soon. Remember there is lots of advice available in this blog and elswhere online for treating D&V and getting better afterwards:

http://connaughthall.blogspot.co.uk/search/label/diarrhoea

http://www.patient.co.uk/health/Gastroenteritis-in-Adults.htm

http://www.nhs.uk/conditions/diarrhoea/Pages/Introduction.aspx

Getting back to full health after diarrhoea & vomiting

Helping yourself get better after being ill with diarrhoea and vomiting:

Make sure you drink plenty of water in the first two days after your illness – aim for 3 litres / 24 hours. Dehydration can make you feel really weak and tired. Dioralyte is useful – it contains the right balance of salts for your body and can really pick you up quickly from dehydration. You can buy Dioralyte at any pharmacy.

Get some energy inside you: (flat) fizzy drinks like lemonade (not the diet kind) are good for this.
If you’re a regular caffeine drinker, you may be withdrawing from caffeine a bit after a day or more of vomiting and reduced intake. “Pro plus” or flat Coke will help you get over this withdrawal feeling.

Use paracetamol (1g up to four times a day) to help relieve any muscular aches and pains or headache. If you have stomach cramps, Buscopan – available at any pharmacy – is really good.

Infection control precautions

Handwashing is one of the most important ways of controlling the spread of infections, especially those that cause diarrhoea and vomiting, and respiratory disease. Use liquid soap, warm water and paper towels / hand dryer. Cover all cuts and abrasions with waterproof dressings.

Always wash your hands after using the toilet, before eating or handling food, and after contact with anyone who is unwell.
Use the dedicated toilets (pink signs) if you are unwell, and for 48 hours after your symptoms have gone. If you are not unwell, do not use the pink sign toilets: only use the toilets with a green sign.

If you are unwell, and for 48 hours afterwards, try to stay in your room and limit visitors as much as you can. It's not practical to achieve complete isolation, but the more you can stay away from residents who are well, the sooner this outbreak will die out.

Try not to invite guests from outside the Hall to come in while this outbreak is ongoing. If you do have outside guests, warn them about washing their hands.

If you are unwell, and for 48 hours afterwards, do not touch or prepare food for anybody else.

Laundry: wash your bed sheets and clothes on the hottest temperature the fabric can take. Use the "whites" or "hot" feature on the washing machine; this should be up to 60 degrees - but make sure your clothes can be safely washed at this temperature first. Contact the Bursar's Office if you have any visibly soiled bed linen.

Coughing and sneezing easily spread infections.Cover your mouth and nose with a tissue. Wash hands after using or disposing of tissues. Spitting should be discouraged.

Avoid touching your eyes and mouth. The most common route of infection is from your hands and into your body through the eyes or mouth when you touch your face.

Cleaning of the environment should be frequent, thorough and follow national guidance. We have increased our cleaning schedules and are using the recommended strength of bleach solution.

Separate toilets for residents who are unwell

In accordance with Health Protection Agency guidance we are designating a communal toilet per floor for those with vomiting and diarrhoea symptoms. Each toilet will have a pink sign and will be for both male and female residents.

Please could all other residents use the other toilet further along the corridor, and again for both male and female residents. This will have a green sign on the door.

These arrangements will be in place until further notice.

Once again may I stress the crucial importance of strict hand hygiene for EVERYONE. Use the alcohol gel. But remember the best hand hygiene is from thorough washing with soap and water.

Individuals affected can remain infectious for up to 48 hours after their symptoms have gone, so if you have been unwell, keep up your hand washing and try to avoid contact with unaffected people for 2 days after your last episode of diarrhoea.

Diarrhoea & vomiting update

We now have 25 reported cases of diarrhoea and vomiting in the Hall. The Health Protection Agency (HPA) have been involved and they are treating this as a Norovirus outbreak at present. This is unlikley to be food related but our caterers will continue their full food safety review. We expect to have microbiology data within 72 hours and then we should know exactly what has caused this illness. Remember you can tell us that you are unwell by emailing sicknessreporting@connaught-hall.org.uk.

There is more information about diarrhoea & vomiting here: http://www.patient.co.uk/health/Gastroenteritis-in-Adults.htm.

I must again stress the crucial importance of strict hand hygiene for EVERYONE. Use the alcohol gel. (Don't steal it - the 2nd floor dispenser disappeared within hours of us putting it out, and we don't have any more yet!) But remember the best hand hygiene is from thorough washing with soap and water.

We have implemented increased cleaning of bathrooms and other areas with disinfectant to help prevent spread of illness.

Individuals affected can remain infectious for up to 48 hours after their symptoms have gone, so if you have been unwell, keep up your hand washing and try to avoid contact with unaffected people for 2 days after your last episode of diarrhoea. The HPA, however, are being pragmatic and understand that this is exam time so you may have to go to your exams, so long as you fee better, without observing this 48-hour exclusion rule.

So that I do not have to keep filling your inbox with email, further updates will be posted on my blog here: http://connaughthall.blogspot.co.uk/search/label/diarrhoea and links to those posts will be published via Facebook and Twitter (@connaughthall).

I hope everyone affected feels better soon. Let us know if we can help in any way.

Update on diarrhoeal illness

We are now aware of 18 students in Hall with gastro-intestinal symptoms overnight.

REPORTING:
If you've been unwell with diarrhoea in the last 12 hours, please contact the Bursar's Office today or email sicknessreporting@connaught-hall.org.uk. Please visit your GP today if possible, tell them several residents have been unwell with the same symptoms, and ask if they will send a stool sample for you. The purpose of a stool sample is to figure out what organism has caused this outbreak. This can help guide your treatment (e.g. indicate whether antibiotics might be useful) but we also need to know if this is a virus spread from one resident to another or if it might be food poisoning.


TREATMENT:

Remember to drink plenty of clear fluids, use paracetamol to relieve pain and/or fever, and let a friend know that you're unwell. Please observe strict hygiene in the bathrooms and elsewhere to avoid passing any bugs to others! There is more advice about self-treatment of diarrhoea and vomiting here: http://www.nhs.uk/Conditions/Diarrhoea/Pages/Treatment.aspx.
You must definitely see a doctor if your symptoms last more than 72 hours, if you collapse or feel faint when you stand up, or if there is blood in your stool. you may also need to see your doctor if you have an exam in the next few days: it will be useful to have medical confirmation that you have been unwell, in case you need to make a mitigating circumstances claim or miss your exam.
A doctor from 20 Gower Street Pactice is coming to Connaught Hall around 12.30 this afternoon. If you have informed us before then that you are unwell, we may be able to have the doctor come to see you in your room. Use the sicknessreporting@connaught-hall.org.uk email address.


PREVENTION:
If you are not affected by any symptoms, please remember to wash your hands thoroughly with soap and water after using the bathroom or visiting anyone who is unwell. This will help ensure you don't catch anything. We have cleaners working to disinfect all the toilet blocks this morning.

We have placed alcohol hand sanitiser pumps at reception and on every floor. There is also a pump on the wall in the dining hall. These can help hand hygiene but are not a substitute for proper hand washing with soap and water: some stomach bugs are partly resistant to the hand gel but are easily washed off with soap and water.


INVESTIGATION:
As mentioned above, stool samples are important to help us work out what has caused this illness and whether the local authorities need to be involved. There is currently no evidence of a connection with food: those affected ate different things at dinner last night. This could just as easily be a norovirus outbreak, which is usually spread by personal contact rather than through food. Of course the kitchen will review the food temperature logs to ensure everything was kept hot enough last night, and send samples of any leftovers for analysis.


I hope everyone affected by this feels better soon. If you are not affected, please don't worry: just wash your hands carefully and you should stay well!

Have you been unwell with diarrhoea today?

If you've been unwell with diarrhoea in the last 12 hours, please contact the Bursar's Office today (Tue) or email sicknessreporting@connaught-hall.org.uk. Please visit your GP today if possible, tell them several residents have been unwell with the same symptoms, and ask if they will send a stool sample for you. This will help us work out which bug has caused people to be unwell, and maybe where ...it came from.

Remember to drink plenty of clear fluids, use paracetamol to relieve pain and/or fever, and let a friend know that you're unwell. Please observe strict hygiene in the bathrooms to avoid passing any bugs to others! There is more advice about self-treatment of diarrhoea and vomiting here: http://www.nhs.uk/Conditions/Diarrhoea/Pages/Treatment.aspx.

If you are not affected by any symptoms, please remember to wash your hands thoroughly with soap and water after using the bathroom or visiting anyone who is unwell. This will help ensure you don't catch anything.