Surg J R Coll Surg E
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Surg J R Coll Surg E · Jun 2006
Randomized Controlled TrialLessons learned from a randomised controlled study of perioperative beta blockade in high risk patients undergoing emergency surgery.
Perioperative beta blockade has been shown to reduce mortality after major elective surgery. The aim of this study was to determine whether it could reduce the rate of death and morbidity from cardiac complications in high risk patients undergoing emergency surgery. ⋯ This study of emergency surgery proved more difficult than similar trials in elective surgery. The final study groups were small and there were no significant differences in outcomes. A much larger study is required for a definitive answer.
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A survey was undertaken to assess surgical team members' attitudes to safety and teamwork in the operating theatre. ⋯ Attitude surveys can provide useful diagnostic information relating to behaviour and safety in surgical units. Discrepancies were found between the views of consultants compared with trainees and nurses, in relation to leadership and teamwork. While attitudes to safety were generally positive, there were several areas where theatre staff did not seem to appreciate the impact of psychological factors on technical performance.
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Surg J R Coll Surg E · Jun 2006
Case ReportsMucosal tear in the oropharynx leading to pneumopericardium and pneumomediastinum: an unusual complication of blunt trauma to the face and neck.
Pneumomediastinum and pneumopericardium are very rare complications resulting from blunt trauma to the head and neck. We report the case of a 40-year-old male who had been assaulted. He presented to the Emergency Department with bruises to the face and neck and complained of dysphagia. ⋯ He was managed conservatively and made an uneventful recovery. This is a very rare but potentially life-threatening complication of blunt trauma to the head and neck. It poses diagnostic difficulties and treatment dilemmas, which are discussed.