British journal of anaesthesia
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On March 4, 2018, two casualties collapsed on a park bench in Salisbury, Wiltshire, UK. They were later discovered to have been the victims of an attempted murder using the Soviet-era Novichok class of nerve agent. ⋯ Before the COVID-19 pandemic, the Salisbury and Amesbury incidents were the longest-running major incidents in the history of the UK National Health Service. This narrative review seeks to reflect on the lessons learned from these chemical incidents, with a particular focus on hospital and local organisational responses.
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Randomized Controlled Trial Multicenter Study Comparative Study
Intravenous iron to treat anaemia following critical care: a multicentre feasibility randomised trial.
Anaemia is common and associated with poor outcomes in survivors of critical illness. However, the optimal treatment strategy is unclear. ⋯ ISRCTN13721808 (www.isrctn.com).
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Five million surgeries take place in the NHS each year. Little is known about the prevalence of chronic diseases among these patients, and the association with postoperative outcomes. ⋯ One in four surgical patients has a chronic disease with an associated 10-fold increase in risk of postoperative death. Two-thirds of all deaths after surgery occur among patients with high-risk diseases (cancer, cardiac failure, liver disease, dementia).
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Observational Study
Association between case volume and mortality in pre-hospital anaesthesia management: a retrospective observational cohort.
Pre-hospital anaesthesia is a core competency of helicopter emergency medical services (HEMS). Whether physician pre-hospital anaesthesia case volume affects outcomes is unknown in this setting. We aimed to investigate whether physician case volume was associated with differences in mortality or medical management. ⋯ Mortality appears to be lower after pre-hospital anaesthesia when delivered by physician providers with higher case volumes.
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Artificial intelligence (AI) has the potential to personalise mechanical ventilation strategies for patients with respiratory failure. However, current methodological deficiencies could limit clinical impact. We identified common limitations and propose potential solutions to facilitate translation of AI to mechanical ventilation of patients. ⋯ Development of algorithms should involve prospective and external validation, with greater code and data availability to improve confidence in and translation of this promising approach.