Brit J Hosp Med
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Anaesthetists' use of positive end-expiratory pressure during elective general anaesthesia via supraglottic airway devices varies. Positive end-expiratory pressure may help to maintain oxygenation and prevent atelectasis, but could worsen the risk of air leak, gastric insufflation and catastrophic aspiration.
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The trauma and orthopaedic surgery department needed to modify practices as a result of the COVID-19 pandemic. This study quantitatively assessed the effects of changes in resource allocation on the efficiency of trauma, specifically the number of operations performed per defined trauma session. ⋯ Measures introduced at the start of the pandemic are likely to continue for the foreseeable future. Increased allocation of resources would be needed to allow urgent trauma surgery to provide a timely and efficient service.
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Topical medications are key agents in treating a range of skin conditions, as they allow affected areas to be targeted while avoiding systemic side effects. Although there is a wide range of topical agents available, it is helpful to be familiar with a few commonly used formulations. This article describes how to select appropriate agents, prescribe appropriate quantities, and counsel patients on safe and effective treatment regimens.
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Patella dislocation is one of the most common knee injuries, accounting for 3% of acute knee injuries. Despite its prevalence, patella dislocation is often missed, with a haemarthrosis often the only sign, albeit a non-specific one. ⋯ Management in the acute setting is normally non-operative, but damage to structural supports, osteochondral defects or recurrent dislocation should prompt consideration of operative treatment. Operative treatment should address the soft tissue stabilisers and/or osseus deformities that predispose to, or occur secondary to, patella dislocation.
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The over-representation of bullying in healthcare is incongruent with the compassion of healthcare professionals. This issue needs to be addressed at the levels of medical training and organisation by extending the emphasis on compassionate patient care to include care for co-workers.