Journal of the Royal College of Physicians of London
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J R Coll Physicians Lond · Nov 1997
Randomized Controlled Trial Clinical TrialLocal anaesthetic infiltration prior to arterial puncture for blood gas analysis: a survey of current practice and a randomised double blind placebo controlled trial.
Infiltration with local anaesthetic (LA) is recommended before arterial puncture (AP) for blood gas analysis. A telephone survey of 100 junior hospital doctors established that 84% never used LA; the reason for this cited by 47% of doctors was that they considered the injection to be as painful as AP itself. We therefore undertook a randomised double blind placebo controlled trial to establish whether the recommendation for LA is justified. ⋯ This study supports the recommendation that LA should be infiltrated before radial artery puncture is performed. The belief that the use of LA makes the procedure more difficult and is as painful as arterial puncture should be dispelled.
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To assess the extent of junior doctor involvement in clinical audit, the degree of support from audit staff, and the perceived value of the resulting audits. ⋯ A large proportion of junior doctors are involved in audit projects that do not conform to established good practice and which have a low impact on clinical behaviour. Although junior doctors feel that there is inadequate assistance and poor supervision whilst performing audit, they still support the principle of audit. There is a need to improve the quality and supervision of audit projects performed by junior doctors.
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J R Coll Physicians Lond · Nov 1997
Randomized Controlled Trial Clinical TrialHypoxaemia and supplemental oxygen therapy in the first 24 hours after myocardial infarction: the role of pulse oximetry.
To assess the incidence and degree of hypoxaemia in patients with acute myocardial infarction and evaluate the nation-wide perception and usage of oxygen therapy. ⋯ Hypoxaemia occurs frequently in patients in the first 24 hours after acute myocardial infarction. It is effectively and easily treated with supplemental oxygen which can be guided by pulse oximetry. This is rarely done. Measurements of oxygen saturation are therefore justified in all patients to guide oxygen therapy unless there is a decision to give all patients supplemental oxygen: this we believe to be unnecessary.