Clin Med
-
Case Reports
Lesson of the month. (1). What lies beneath the surface? Diagnosis. Churg-Strauss syndrome.
This reports describes the development of a rash in a 43-year-old man with asthma, who was admitted to the respiratory clinic with dyspnoea, leucocytosis and a productive cough. His symptoms progressed and he was admitted to the high-dependency unit for respiratory support. ⋯ The key message from this particular case was the importance of early diagnosis of Churg-Strauss syndrome, in which a rash is combined with marked peripheral eosinophilia and signs of respiratory distress. Early intervention will reduce the risks of morbidity and mortality in patients with this rare, life-threatening syndrome.
-
This column explores the links and synergies between medicine and literature. What roles can literature play in reflecting and influencing good practice, and what sorts of images of doctoring are to be found in drama, poetry, fiction, biography, electronic fora and film? The editors would be pleased to receive short papers, ranging from 500–1,000 words, on relevant topics. Those interested in contributing should email brian.hurwitz@kcl.ac.uk or neil.vickers@kcl.ac.uk
-
Comparative Study
Introducing physician assistants into an intensive care unit: process, problems, impact and recommendations.
The National Health Service (NHS) is facing substantial staffing challenges arising from reduced working hours, fewer trainees and more protected training of those trainees. Although increasing consultant-delivered care helps to meet these challenges, there remains a need to remodel the workforce. One component of the solution is physician assistants (PAs), who are professionals trained in patient assessment and care, working under the supervision of trained doctors. ⋯ When surveyed at 10 months, PAs were undertaking most PICU procedures, albeit with some supervision. The study shows that PAs can be a valuable addition to the medical workforce, but that predictable problems can mar their introduction. Solutions are suggested for other units intending to follow this model.