Brit J Hosp Med
-
Peripheral artery disease of the lower limbs is a chronically progressive disorder characterised by the presence of occlusive lesions in the medium and large arteries that result in symptoms secondary to insufficient blood flow to the lower extremities. It is both a manifestation of systemic atherosclerosis and a marker of increased cardiovascular morbidity and mortality. Because of its highly heterogenous clinical picture, a detailed history and physical assessment, a high degree of suspicion for peripheral artery disease and the use of the ankle-brachial pressure index is essential to identify patients with peripheral artery disease. This will allow early administration of basic pharmacotherapy and lifestyle changes to reduce cardiovascular events, minimise claudication symptoms and enable optimal revascularisation to prevent loss of limb function.
-
Multimodality perioperative interventions could accelerate patient recovery and improve cost-effectiveness. An evidence review found an association between enhanced recovery after surgery and decreased length of stay, while complications and recovery time were unchanged or reduced. More specialties should develop and implement enhanced recovery after surgery pathways.
-
The rapid sequence induction has been a cornerstone of anaesthetic teaching since it was first described in 1970. Although the technique is taught as a standard protocol there is considerable variation in its practice. So, can we reach consensus over what to include in 'the safe, textbook version' of a rapid sequence induction in modern anaesthesia?