Brit J Hosp Med
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Many doctors take time out of clinical practice, and then have decreased confidence and poor performance ratings on their return. Simulation training provides a safe and effective learning platform for healthcare professionals to become immersed in realistic scenarios that provide an opportunity to develop technical and non-technical skills. ⋯ Quantitative and qualitative analysis showed a significant pre/post-course increase in candidates' self-reported confidence in returning to practice along with learning in non-technical skills. The carefully designed standardised format may facilitate wider expansion of such training.
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Urological trauma is frequently encountered in patients with high energy pelvic fractures and can have debilitating long-term sequelae for patients without appropriate multidisciplinary management. Anterior pelvic ring disruption causes a high incidence of bladder rupture and urethral injuries, and initial assessment requires urological tract imaging and emergent bladder drainage before subsequent surgical repair. ⋯ Optimisation of patient outcomes relies heavily on collaborative management between orthopaedic and urological specialists and requires an appreciation of the anatomical intricacies of the pelvis. This article provides an overview of the British Orthopaedic Association Standards for Trauma and Orthopaedics management of urological trauma in the context of pelvic fractures.
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Anaesthetists commonly debate whether lidocaine should be added to propofol for anaesthetic induction. The benefits include pain relief and improved patient satisfaction, but disadvantages include the effect on the emulsion itself, the efficacy of propofol once it has been mixed, and the effect on growth of bacteria in the syringe.