Brit J Hosp Med
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In 2021 the Royal College of Emergency Medicine and the Faculty of Intensive Care Medicine collaborated to launch the 'Better together' framework to improve outcomes for critically unwell patients in the resuscitation room. One year on from the launch, it remains more relevant than ever.
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Breaking bad news is a challenging station in postgraduate exams. Candidates can struggle if they have not practised delivering sensitive information in a professional and empathetic way. Limited experience of using this clinical skill as a junior doctor often compounds candidates' uncertainty in exams. ⋯ This is a stepwise approach that allows candidates to break bad news in a structured way. This is beneficial in clinical practice, but is also invaluable in postgraduate exams, which often have prescriptive marking schemes. This article highlights the key topics and pitfalls that candidates may encounter and suggests tips for success in exams.
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Environmental dry surface biofilms are a new type of biofilm found on dry surfaces, that are not visible to the human eye. Dry surface biofilms harbour multidrug-resistant organisms, are resistant to cleaning and disinfection and cannot be detected by wet or dry swabbing, so may play an important role in the persistence of pathogens in the healthcare environment.
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Metabolic acidosis is a common complication among acutely unwell hospitalised patients. Untreated, it can result in undesirable cardiovascular, respiratory and neurological consequences. ⋯ A systematic approach can help simplify the assessment of patients and can aid in establishing the correct diagnosis, even in more complex cases. This article provides a practical, step-by-step guide for the assessment of adult patients with metabolic acidosis.
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Acute myeloid leukaemia is a rare cancer, with about 3000 cases diagnosed each year in the UK. Diagnosis is based on patient history, blood and bone marrow tests and, in some cases, imaging. Chemotherapy is the mainstay of treatment for acute myeloid leukaemia, with eligible patients also undergoing allogeneic haematopoietic stem cell transplantation, which can be curative. ⋯ Improvements in transplant technology have increased donor availability and reduced transplant toxicity. At the same time, greater understanding of the cytogenetics and molecular genetics of acute myeloid leukaemia have helped to ensure that patients receive treatment that gives them the best chance of survival. A recent roundtable discussion considered how current diagnostic and treatment pathways might be adapted or enhanced to leverage good outcomes for the greatest numbers of patients.