Brit J Hosp Med
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The forearm is the most common site of fracture in children. At the time of initial assessment, a thorough examination and neurovascular assessment of the limb is necessary. X-rays allow evaluation of the fracture location and type, in addition to the degree of displacement. ⋯ Manipulation and casting should be followed by orthogonal radiographs and a repeated neurovascular assessment of the limb. Oral analgesia and safety netting information should be provided on discharge and the child should be reviewed in fracture clinic within a week of the injury. This article reviews the British Orthopaedic Association Standards for Trauma and Orthopaedics for the early management of paediatric forearm fractures that do not require operative management.
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This study aimed to explore definitions of diversity, and views and attitudes towards diversity in healthcare among future generations of surgical trainees. ⋯ Important components of diversity continue to be under-recognised. Surgery must maximise diversity to attract, support and motivate the next generation of surgeons, for the benefit of the health service and the populations it serves.
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Patient-controlled analgesia with remifentanil is usually reserved for patients for whom other forms of pain relief are contraindicated. However, remifentanil patient-controlled analgesia reduces the likelihood of needing an epidural and therefore the risk associated with it, provides good pain relief compared to other options, and the risks can be mitigated with appropriate management.