Brit J Hosp Med
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Failure to recognise the deteriorating patient can cause severe harm and is related to preventable death. Human factors are often identified as contributing factors. Simulation-based education is used to develop clinicians' human factors skills. ⋯ The evidence demonstrating the impact of simulation-based education on patient outcomes was equivocal. The quality of the evidence was low grade regarding the efficacy of simulation-based education on human factors. Further research is required to confirm the efficacy of simulation-based education for human factors and patient outcomes.
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The role of D-dimers in the management of venous thromboembolism is well established and testing for D-dimers has become common in most acute settings. Although it has been validated for the purpose of excluding venous thromboembolism, the test is increasingly ordered to 'diagnose' venous thromboembolism. Furthermore, in the COVID-19 pandemic, heavy reliance has been put on this test with the inclusion of D-dimers to guide treatment pathways. This review summarises the appropriateness of D-dimer tests in these different clinical settings.
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Anaesthetists' use of positive end-expiratory pressure during elective general anaesthesia via supraglottic airway devices varies. Positive end-expiratory pressure may help to maintain oxygenation and prevent atelectasis, but could worsen the risk of air leak, gastric insufflation and catastrophic aspiration.
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The trauma and orthopaedic surgery department needed to modify practices as a result of the COVID-19 pandemic. This study quantitatively assessed the effects of changes in resource allocation on the efficiency of trauma, specifically the number of operations performed per defined trauma session. ⋯ Measures introduced at the start of the pandemic are likely to continue for the foreseeable future. Increased allocation of resources would be needed to allow urgent trauma surgery to provide a timely and efficient service.
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Historical Article
Sir Felix Semon (1849-1921): distinguished laryngologist.
This year marks the 100th anniversary of the death of Sir Felix Semon, one of the fathers of modern laryngology.