British journal of hospital medicine
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There is nowadays virtually no contraindication to anaesthesia for even small, sick neonates provided that adequate resuscitation is first carried out. Furthermore, apart from severe trauma and airway difficulties, very few paediatric surgical emergencies require immediate intervention. Most emergencies can be treated within a few hours, preferably when the full facilities of the hospital are available.
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The fluid resuscitation of burn injuries in mass casualty situations, such as war, presents a formidable challenge. The possibility of overwhelming numbers of patients to be treated by inexperienced personnel dictates the adoption of a safe, simple and effective regimen. In the burn treatment protocol presented here, this regimen is computed in advance and displayed in a simple tabular form.
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Recently there have been several initiatives to improve the working conditions and training of junior doctors. However, monitoring is infrequent considering the rapid changes in the health service, thus a mechanism to detect early problems is necessary. With this in mind, we have drawn up a charter for house officers that outlines standards which they should expect and the action they should take if they are not met.