Clin Med
-
The outcome of herpes simplex virus (HSV) encephalitis is improved with prompt initiation of aciclovir treatment. Delays are common, but there is little understanding of why they occur. The case notes of 21 adults admitted with suspected HSV encephalitis over one year were reviewed. ⋯ Five (24%) patients were given the wrong dose of aciclovir. Overall the management of suspected HSV encephalitis was often sub-optimal, with delays in LP occurring due to unnecessary CT scans, and the wrong aciclovir dose administered. Guidelines for the management of suspected encephalitis are needed.
-
Mitigating climate change presents unrivalled opportunities for improving public health. The policies that need to be implemented to reduce greenhouse gas emissions will also bring about substantial reductions in heart disease, cancer, obesity, diabetes, road deaths and injuries, and air pollution. ⋯ Because the existence of important health co-benefits will dramatically reduce the cost to society of taking strong action to mitigate climate change, failure to appreciate their importance could have serious environmental consequences. Health professionals have an urgent responsibility to ensure that the health benefits of environmental policies are understood by the public and by policymakers.
-
When offering treatment to a patient with capacity they should be informed of the risks and benefits of therapy and consent should be obtained. For patients without capacity, treatment is given in their 'best interests'. Achieving and assessing capacity to consent for treatment in the presence of acute illness can be difficult and especially so in patients suffering with acute stroke. This article presents patients' and doctors' perspectives on assessing capacity to consent to thrombolytic therapy for stroke.
-
Chest drain insertion may have unintended consequences; this procedure should only be carried out when there are clear indications to do so.