Brit J Hosp Med
-
In the absence of separate guidelines for critically unwell ventilated patients in the intensive care unit who are undergoing surgery, questions arise about whether patients in intensive care should be starved preoperatively, despite already having a protected airway.
-
The National Emergency Laparotomy Audit highlighted that older people living with frailty have poorer outcomes from emergency laparotomies. This editorial discusses some improvements in care that are needed to improve outcomes in this group of patients.
-
The European Medicines Agency's Pharmacovigilance Risk Assessment Committee has issued statements regarding limiting the use of high-dose oestradiol creams by women experiencing the genitourinary syndrome of menopause, and such statements carry much medicolegal weight. Although a low dose is most often used, some clinicians opt to use higher dose creams with close monitoring of the patient. The committee should publish the evidence behind these statements or amend its official position.
-
Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or 'being a doctor'. ⋯ Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.