British journal of hospital medicine
-
Junior doctors, and to a lesser extent medical students, suffer higher rates of stress and depression than the general population. While some of the causes of these problems may lie with the individual, others are associated with organizational and career factors and with a training which still does not prepare them for those first postgraduate years.
-
Administration of intravenous fluids during surgery is commonplace, yet there is enormous variation in the type and quantity of fluid given. That so few problems have been encountered is testimony to the body's ability to deal with extreme variations in hydration. A considerable amount of research would be required to achieve a rational approach to fluid balance in every patient; some guidelines can, however, be provided.
-
Appropriate and timely insertion of chest drains can be lifesaving. The radiological absence of lung markings is not exclusively diagnostic of pneumothorax. The insertion of an intrapleural drain should effect an immediate clinical and radiological improvement. Failure to achieve the expected result should prompt a full clinical reassessment.
-
Central venous catheterization is an established procedure in medical, surgical and anaesthetic practice. However, the procedure is not without hazard. One complication that may be life-threatening is air embolism. This article considers the causes of air embolism related to central venous catheterization, its treatment and methods of prevention.