British journal of hospital medicine
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Review
Benefits and risks of thrombolytic, anticoagulant and antiplatelet therapies in atrial fibrillation.
The decision whether to anticoagulate is a common dilemma when faced with a patient with atrial fibrillation. This article reviews the role of warfarin and antiplatelet agents and recommends a rational approach to the management of this condition.
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With the advent of shorter-acting non-depolarizing neuromuscular blocking drugs, the use of nerve stimulation as a means of monitoring the neuromuscular junction has become more widespread. This article describes the patterns of nerve stimulation and modes of monitoring muscular response in current clinical use. These patterns and modes are compared and their clinical relevance is discussed.
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The principles of stabilization before, and monitoring during, transportation are well established in adult intensive care practice but less so in paediatrics. The speed with which critically ill children deteriorate and the aggressiveness of treatment needed are often underestimated. A dedicated, fully funded and staffed transport service for each paediatric referral centre in the UK is urgently required.
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Problem-based learning is now a well-established approach to the design and implementation of undergraduate, postgraduate and continuing medical education. This article describes how it functions and examines how it contributes to more enjoyable and effective professional development.
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All doctors are enjoined to audit, yet there is concern that many audits do not improve patient care. Despite the profusion of audit methods, good audits have many features in common. This paper identifies these essential features, facilitating the appraisal of proposed or completed studies.