The journal of the Royal College of Physicians of Edinburgh
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J R Coll Physicians Edinb · Jan 2013
Comparative StudyViews of the chairs of Scottish health boards on engagement with quality management and comparisons with English trusts.
To describe the views of the chairs of Scottish health boards on the engagement of their boards with healthcare quality and to compare them with the views of the chairs of boards of English acute trusts. The focus of the Scottish Health Boards is on providing and commissioning care, while in England the acute trusts only provide care. ⋯ Although most chairs of Scottish boards view quality as a priority, they pay less attention to it than chairs in England, possibly due to their additional role in commissioning care.
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Hyperkalaemia, an elevated extracellular fluid potassium concentration, is a common electrolyte disorder and is present in 1-10% of hospitalised patients. Elevated serum potassium concentrations are usually asymptomatic but may be associated with electrocardiogram (ECG) changes. Hyperkalaemia occasionally leads to life-threatening cardiac arrhythmias. ⋯ Nebulised β-2 adrenoceptor agonists can augment the effects of intravenous insulin and glucose pending more definitive management of the recurrent hyperkalaemia risk. Additional management steps include stopping further potassium intake and careful review of prescribed drugs that may be adversely affecting potassium homeostasis. Changes to prescribing systems and an agreed institutional protocol for management of hyperkalaemia can improve patient safety for this frequently encountered electrolyte disorder.
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Occupational medicine represents the interface between work and health. As such, its breadth encompasses issues of clinical medicine, epidemiology, occupational hygiene, toxicology, ethics, and the law. ⋯ It is not surprising that many clinicians find this challenging. The aim of this paper is to provide a summary of common work-related lung disorders, and stress the importance of considering a patients' occupation when presented with a range of respiratory symptoms.