Brit J Hosp Med
-
Palliative care should be available to all with a life-limiting illness, including those with dementia. This article examines the palliative needs of those with dementia and how these needs might be met.
-
Tattooing has been around since early civilisation, with origins that can be traced back to Otzi the ice man dating from the fourth to fifth millennium bc (Renaut, 2004). Various methods of tattoo removal are described in the literature ranging from salabrasion as described by Aetius, a Greek physician, in 543ad (Scutt, 1972) to laser treatment in the late 20th century (Goldman et al, 1967).
-
One of the longest running debates in obstetric anaesthesia surrounds the prevention and treatment of maternal hypotension during caesarean section. Anaesthetic techniques have evolved and maternal mortality and morbidity is markedly reduced, but hypotension remains a problem, particularly following neuraxial blockade. Despite over 30 years of research no definitive consensus has been reached on the best treatment strategy and particular controversy surrounds the use of vasopressive agents. This article explores the evidence relating to the three most commonly used agents in the UK: ephedrine, phenylepherine and metaraminol.
-
The 'can't intubate, can't ventilate' scenario is a nightmare for all clinicians who manage airways. Cricothyroidotomy is one of several emergency airway management techniques. Cricothyroidotomy is a short-term solution which provides oxygenation, not ventilation, and is not a definitive airway. ⋯ Cricothyroidotomy provides an opening in the pace between the anterior inferior border of the thyroid cartilage and the anterior superior border of the cricoid cartilage, allowing access to the airway below the glottis. The anatomical considerations are important when performing this procedure (Ellis, 2009), and there are other scenarios when it is used. It is not without consequence, as with any procedure.
-
Pulmonary complications of liver disease are poorly understood and often identified late. Abnormalities of the pulmonary vasculature lead to two distinct complications, hepatopulmonary syndrome and portopulmonary hypertension, which differ in their clinical features and management. This article focuses on these two entities.