Brit J Hosp Med
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Wide awake local anaesthesia no tourniquet, also known as WALANT, is the practice of performing surgery under local anaesthetic in the absence of a tourniquet. This technique uses the vasoconstrictive effects of adrenaline and the local anaesthetic effects of lignocaine to establish a Bier block with haemostatic control. Permitting active patient participation intraoperatively, wide awake local anaesthesia no tourniquet surgery improves patient compliance with rehabilitation and yields higher patient satisfaction. ⋯ This is of particular benefit within the current COVID-19 climate, as wide awake local anaesthesia no tourniquet technique provides a means of overcoming restrictions to theatre access and anaesthetic support. This review delves into the current uses of wide awake local anaesthesia no tourniquet surgery, outlining the initial conception of the practice by Canadian surgeons. The advantages and disadvantages are considered, and potential future applications of this technique are discussed.
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Much is known and reported about sharps injuries among healthcare workers, but there has been a lack of published evidence regarding the psychological impact of sharps injuries among medical students. The purpose of this narrative review was to discover the psychological impact of sharps injuries within the medical student population. ⋯ The review identified six studies conducted in six countries which described the psychological impacts of sharps injuries among medical students as being fear, anxiety, depression and post-traumatic stress disorder. The findings highlight the potential psychological issues created by sharps injuries, and highlights that further research is needed into this topic to aid the education and prevention of this harmful problem.
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This editorial discusses the 'Enhancing Junior Doctors' Working Lives' report from Health Education England and emphasises the importance of junior doctors reading it and engaging with the content.
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There has been a dramatic improvement in mortality rates among children with congenital heart disease with advances in neonatal screening and surgical techniques, resulting in a significant increase in the prevalence of adults living with congenital heart disease. The most common simple lesions of congenital heart disease include atrial and ventricular septal defects, patent ductus arteriosus and coarctation of the aorta, which are typically detected and treated in childhood. However, they may also present in adulthood with non-specific symptoms or incidental findings, such as refractory hypertension. As the adult population of those living with congenital heart disease grows, it is imperative that all clinicians remain abreast of these common cardiac conditions, irrespective of their specialty, as patients may present with sequelae of their congenital heart disease or other non-cardiac conditions.