Clin Med
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Patient choice is becoming the centre of health policy in the UK and other countries. But there is ambiguity about what choice means. As the term is used in everyday life, choice is the foundation of the doctrine of patient consent. ⋯ But consumerism in healthcare is incompatible with a publicly funded service. Moreover, consumerism changes the locus of responsibility from the doctor to the consumer (the patient). The doctor will cease to have the values of a professional and will become simply an agent of the patient's demands.
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Can acute medicine units in the UK comply with the Surviving Sepsis Campaign's six-hour care bundle?
The Surviving Sepsis Campaign (SSC) advocates a six-hour resuscitation care bundle to be used in the initial management of the acutely ill patient. This survey was designed to investigate the number of acute medicine units (AMUs) in the UK capable of, and successful in, implementing this bundle. Questionnaires were sent to each of the 265 AMUs across the UK. ⋯ Twenty AMUs (12%) had the minimum facilities to comply. Regional variation was noted. This survey shows that few AMUs in the UK appear to be able to resuscitate a patient with sepsis using the SSC resuscitation care bundle.
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Practice Guideline
Long-term neurological conditions: management at the interface between neurology, rehabilitation and palliative care.
Long-term neurological conditions (LTNCs) comprise a diverse set of conditions resulting from injury or disease of the nervous system that will affect an individual for life. Some 10 million people in the UK are living with a neurological condition which has a significant impact on their lives, and they make up 19% of hospital admissions. ⋯ This article provides a brief summary. Full details of the methods and literature evaluation, as well as tools for implementation, are available in the full guideline.
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A survey of 70 junior doctors was conducted in 2006 to analyse their attitudes to cardiopulmonary resuscitation (CPR). All had advanced life support training, yet 73% found CPR stressful. Major causes of stress included poor outcome and inappropriate CPR. ⋯ Most junior doctors found discussing CPR with patients/relatives difficult. CPR-related stress may be minimised by creating awareness of the procedure's poor outcome, by ensuring that seniors document CPR status where relevant, and by encouraging junior doctors to undergo debriefing and six-monthly training/updates. Stress arising from discussing CPR with patients/relatives may be minimised by training organised by the employing trust and by increasing patients' understanding of CPR through information leaflets.