Canadian journal of surgery. Journal canadien de chirurgie
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Historical Article
Canadian surgery and the Canadian Journal of Surgery--decades of change.
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There is no systematic review of the methodological quality of randomized controlled trials (RCTs) of teaching surgical and emergency skills to undergraduates. ⋯ This systematic review assessed the quality of RCTs used in teaching undergraduates surgical and emergency skills. There are many positive study outcomes, but there are significant methodological weaknesses in the study design. Students varied in their skills, and most did not demonstrate optimal performance in any of the procedures. This review provides a baseline for further work important to both medical education and clinical practice.
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Hemorrhagic shock is a leading cause of death in trauma patients. Surgical control of bleeding and fluid resuscitation with both crystalloid and blood products remain the mainstay of therapy for injured patients with bleeding. However, there has been a recent re-evaluation of transfusion practice. ⋯ Avoiding overtransfusion is key, however, because transfusion is also associated with significant risks. This trend toward reducing allogenic blood exposure will likely continue. New technologies that have the potential of reducing blood loss and transfusion requirements in trauma patients with massive bleeding are being developed, and similar old technologies are being reapplied.