Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · May 2004
Randomized Controlled Trial Clinical TrialTaking the 'ouch' out - effect of buffering commercial xylocaine on infiltration and procedure pain - a prospective, randomised, double-blind, controlled trial.
To compare the effect of buffered commercial 1% xylocaine (with 1:200,000 adrenaline) and the unbuffered commercial 1% xylocaine (with 1:200,000 adrenaline) preparation on pain during infiltration and procedure. ⋯ Use of buffered xylocaine is a simple, inexpensive and significantly effective way of reducing pain during infiltration and in surgical procedures performed under local anaesthesia.
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The UK Department of Health (DoH) introduced a new consent form into the National Health Service (NHS) in April 2002 following the Bristol Royal Infirmary Inquiry. ⋯ The new consent form resulted in improvement in some, but not all, aspects of consent and no question reached the ideal standard of 100%. We suggest a formatted consent form for procedures in conjunction with additional information.
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Ann R Coll Surg Engl · May 2004
Balancing priorities in the management of hip fractures: guidelines versus resources.
About 60,000 patients are treated for hip fractures each year in the UK and the incidence is increasing. The majority of these patients are elderly and sick, and delay to operation may be fatal. The National Confidential Enquiry into Peri-Operative Deaths (NCEPOD) guidelines aim to improve quality of care for such patients. However, we present an audit highlighting the importance of balancing the implementation of such guidelines with available local resources to ensure that established priorities in the care of these patients remain paramount. ⋯ For such guidelines to be implemented, adequate resources should first be provided. In the absence of these resources, clinicians must balance the need for adequate pre-operative assessment with the need for urgent surgery.