Scot Med J
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National Institute for Health and Clinical Excellence guidelines recommend the use of 'Track and Trigger' systems to identify early clinical deterioration. The Standardised Early Warning Score (SEWS) is used in the Royal Infirmary of Edinburgh. Previous work, suggested that the frequency and accuracy of SEWS documentation varied throughout the hospital. ⋯ SEWS recording and documentation was significantly better in CAU (P < 0.001, FET), where there is a dedicated, ongoing SEWS education programme for nursing and medical staff. We recommend this is rolled out across the hospital. Alternative methods of improving the use of SEWS are considered.
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Acute kidney injury (AKI) is not uncommon in acute hospital admissions. AKI treated with renal replacement therapy (RRT) has a wide spectrum of causes and the mortality rate at 90 days, approaches 50%. This study was performed to analyse the identifiable causes and outcomes of all cases of AKI treated with RRT in the Glasgow Royal Infirmary (GRI) renal wards during 2007. ⋯ Sepsis, hypovolaemia and nephrotoxic drugs were the main contributory factors and were observed in 52%, 40% and 23% of the cases, respectively. The mortality rate was 29% at 90 days. This study shows that the aetiology of AKI is often multifactorial and the 90-day mortality rate of AKI treated with RRT is still high.
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Injecting drug users are prone to atypical infections. We present a case of septic thrombophlebitis secondary to Fusobacterium gonidiaformans infection in a heroin user, which demonstrates the frequently unusual nature of pathogens and presentations in this group of patients.