Brit J Hosp Med
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Urological trauma is frequently encountered in patients with high energy pelvic fractures and can have debilitating long-term sequelae for patients without appropriate multidisciplinary management. Anterior pelvic ring disruption causes a high incidence of bladder rupture and urethral injuries, and initial assessment requires urological tract imaging and emergent bladder drainage before subsequent surgical repair. ⋯ Optimisation of patient outcomes relies heavily on collaborative management between orthopaedic and urological specialists and requires an appreciation of the anatomical intricacies of the pelvis. This article provides an overview of the British Orthopaedic Association Standards for Trauma and Orthopaedics management of urological trauma in the context of pelvic fractures.
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Anaesthetists commonly debate whether lidocaine should be added to propofol for anaesthetic induction. The benefits include pain relief and improved patient satisfaction, but disadvantages include the effect on the emulsion itself, the efficacy of propofol once it has been mixed, and the effect on growth of bacteria in the syringe.
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The COVID-19 pandemic has necessitated unprecedented changes to the functioning of hospitals across the world. This article evaluates the acute impact of COVID-19 on the provision of symptomatic breast services in the UK and explores suggestions for more sustainable functioning of services in the post-COVID-19 era.
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The management of acute ischaemic stroke has been revolutionised by effective reperfusion therapies including thrombolysis and mechanical thrombectomy. In particular, mechanical thrombectomy has heralded a new era in stroke medicine. There have also been developments to improve clinical outcomes for patients who have had an acute ischaemic stroke but are not eligible for this procedure. This article presents an update on the initial management of acute ischaemic stroke, including reperfusion therapies, periprocedural considerations and ongoing research for potential improvements in the care of these patients.