Scot Med J
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Frostbite injury from cold exposure is not uncommon. The application of ice pack is well known in clinical practice; however, its improper use can pose danger to the patient. We report a case of frostbite injury due to prolonged use of ice packs in a ventilated patient.
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The aim of this paper is to examine perceptions of Foundation Year trainees, consultants and senior nurses about the introduction of the Foundation Programme. Specifically, to examine whether Foundation trainees acquire appropriate skills, experience and responsibility. Semi-structured interviews were conducted with 23 F1 doctors, 22 F2 doctors, 23 consultants and 25 nurses from across Scotland in a broad range of specialties. ⋯ Trainees feeling that they are being given insufficient experience, particularly in the F2 year, need to be proactive in addressing this if possible. There is a perception among some consultants and nurses that a process of 'delayed skilling' is taking place, attributable more to reduced hours than Foundation per se. There is a need to follow trainees through to specialty training to ascertain if Foundation has adequately prepared them for run-through training.
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The ability to acquire surgical skills requires consistent practice, and evidence suggests that many of these technical skills can be learnt away from the operating theatre. The aim of this review article is to discuss the importance of surgical simulation today and its various types, exploring the effectiveness of simulation in the clinical setting and its challenges for the future. Surgical simulation offers the opportunity for trainees to practise their surgical skills prior to entering the operating theatre, allowing detailed feedback and objective assessment of their performance. ⋯ Inorganic simulators comprise virtual reality simulators and synthetic bench models. Current evidence suggests that skills acquired through training with simulators, positively transfers to the clinical setting and improves operative outcome. The major challenge for the future revolves around understanding the value of this new technology and developing an educational curriculum that can incorporate surgical simulators.
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We present a case of delayed presentation of a traumatic duodenal rupture in a 15-year-old boy. He presented 12 hours after falling six feet and sustaining blunt trauma to his anterior abdominal wall. On arrival in the Emergency Department he was shocked and peritonitic. ⋯ Duodenal rupture is a rare but serious complication of blunt abdominal trauma. Diagnosis is difficult but missed diagnosis and delayed presentation is associated with high morbidity and mortality. A high index for suspicion must be kept when dealing with blunt abdominal trauma to ensure this is not missed.
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Prescribing in the perinatal period is based on a risk-benefit analysis, in the context of a limited evidence base, composed primarily of case series and reports. Mothers with depressive illness often present first in the community and effective treatment is paramount for the wellbeing of both mother and child. We aimed at investigating current prescribing practices among general practitioners (GPs) of antidepressants to mothers presenting in first trimester of pregnancy and during breastfeeding. ⋯ Only one GP suggested consulting clinical guidelines when making prescribing choices. There was no mention of the continuation of an antidepressant from pregnancy into breastfeeding as a reason of choice. Inconsistent prescribing patterns among GPs could have implications for the wellbeing of mother and child, and may be reflective of an underlying educational need among GPs.