Brit J Hosp Med
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Maintaining emergency eye services is crucial during the COVID-19 pandemic. This article describes the introduction of a new restructured referral pathway to reduce the burden on healthcare providers and create a safe environment. ⋯ Using this telephone and digital imaging review triage system, the authors have demonstrated a significant reduction in the need for face-to-face reviews. The reduction in avoidable patient face-to-face reviews allows the system to move from saturated to sustainable while increasing accessibility to services for patients who may not be able to present for face-to-face review. This complete audit cycle successfully charts interventions that maximise accessibility, reduce unnecessary hospital visits and deliver safe and prompt management during the pandemic.
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Dizziness and balance disorders are very common problems. Having a structured approach, including adequate history taking and clinical examination, in a multidisciplinary environment allows for effective management of patients with these complex symptoms. ⋯ While surgical intervention has a small role in the management of balance disorders, vestibular rehabilitation remains the cornerstone of treatment, along with different supportive measures. This article outlines the approach used in the authors' centre to manage patients with dizziness and balance disorders.
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The death of a patient is one of the most stressful situations a healthcare professional can face for the first time at work or during training. Palliative and end of life care education aims to impart appropriate awareness and understanding of key issues arising at the end of life, but also to develop learners' interpersonal skills in leadership, communication and management of their own emotional load. There is a pressing need to be explicit around death, dying and care at the end of life and to equip clinical staff with the ability to manage the emotions that are experienced by their patients, their teams and themselves. Emotional intelligence is considered as a framework for medical educators to use in this setting with presentation of a simulated patient vignette to contextualise this.
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In a change from recalling births, deaths or medical discoveries, this article looks at a paper published in The Lancet 100 years ago. Occupying a little more than a single column, its vivid description of an operation carried out successfully under primitive conditions will be of great interest.
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The interface between the Mental Capacity Act 2005 and the Mental Health Act 1983 can be complex, particularly in patients with co-existing mental and physical illnesses. The management of these patients requires the involvement of patients, relatives and multidisciplinary teams. This article presents four illustrative patient cases, all of whom suffered from co-existing mental and physical illnesses. ⋯ Often, principles from both legal frameworks may be applied by the treatment team. These cases help to highlight the significant overlap between mental and physical health, which often cannot be managed independently. This may call for the need to better integrate the current legal frameworks, and the optimal involvement of specialists across both settings.