Brit J Hosp Med
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Nasogastric tubes are used frequently in surgical patients for bowel decompression, provision of enteral nutritional support and preventing aspiration of gastric contents. There is no conclusive research into the risk of COVID-19 transmission associated with nasogastric tube insertion, although evidence from the severe acute respiratory syndrome outbreak appears to suggest that there is no increased risk of transmission. ⋯ In addition, the nasogastric tube can expose the healthcare worker to potentially infectious saliva. Therefore, there is a clear need for increased evidence regarding the risk of transmission associated with nasogastric tube insertion, to ensure that such risks can be mitigated.
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Anorexia nervosa is an eating disorder with peak onset in adolescence, which carries the highest mortality rate of all psychiatric illnesses. It is commonly comorbid with other physical and mental health problems, yet training on management of people with eating disorders and working knowledge of clinicians working with underweight adolescents is inconsistent. This review of anorexia nervosa in adolescents provides an overview of the presentation, aetiology and treatment of this disorder, with a particular focus on the assessment and management of physical health risks, including refeeding syndrome.
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Distal radius fractures account for one in five bony injuries in both primary and secondary care. These are commonly the result of a fall on outstretched hands or high-energy trauma. On assessment, clinicians should determine the mechanism of injury, associated bony or soft tissue injuries, and neurovascular symptoms. ⋯ Patients should be encouraged to mobilise as soon as it is safe to do so, to prevent stiffness. Median nerve compression is the most common complication followed by tendon rupture, arthrosis and malunion. This article outlines the British Orthopaedic Association Standards for Trauma and Orthopaedics for the management of distal radius fractures.