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This article in The Lancet Haematology examines the impact of having different anaemia thresholds for men and for women at different life stages. It challenges the data that current medical assumptions are based on, arguing that they have been extrapolated from healthy, predominantly white populations that are not representative of real-world populations. The authors look at the arguments that has been used to determine sex-based differences in haemoglobin concentrations, and argue that there is limited evidence to justify having different anaemia thresholds for men and women. They suggest that removing sex-specific reference ranges for haemoglobin and ferritin may improve the health of women and their offspring.

Professor Ahmet Fuat, North East and North Cumbria Cardiac Network Heart Failure Lead, shares how one tool is helping reduce the current pressures and deliver better outcomes for patients. NT-proBNP testing – a NICE recommended diagnostic tool – is being used to rule out heart failure in primary care. In the North East and North Cumbria, patients must have an NT-proBNP test to be referred for an echocardiogram. This mandated testing helps them to streamline the diagnosis journey for heart failure patients by confirming or ruling out heart failure at the earliest possible opportunity, and reducing unnecessary referrals for echos. For patients, this saves time and distress, and for GPs and Nurse Practitioners, which reduces the number of repeat visits these patients often need to make.

Serious Hazards of Transfusion (SHOT) introduced a new Human Factors Investigation Tool (HFIT) in 2021. The tool can be used to investigate and capture systemic as well as individual factors where there has been an error. This case study uses the updated Human Factors Investigation Tool and Systems Engineering Initiative for Patient Safety (SEIPS) framework to work through an ABO incompatible red cell transfusion case reported to SHOT.

The efficacy of injection therapy in diabetes depends on correct injection technique. The aim of the Insulin Injection Technique Questionnaire was to understand how people with diabetes inject, so that guidance can be tailored towards improving injection technique. This article in the Journal of Diabetes analyses the results of the 2008-2009 survey and identifies areas where improvements have been made since the last survey, and areas where there is still progress to be made.

This article discusses a new consultation that has been launched by Robert Francis QC regarding the terms of reference for an independent study into the infected blood scandal. The article covers the suggested scope, the approach and the rationale behind the research and what it won't do, such as run through evidence already heard by the Inquiry.

Tension pneumothorax can occur following chest trauma, respiratory disease and infection, or during resuscitation requiring invasive or non-invasive ventilation. It is a life-threatening condition resulting from a collapsed lung when air trapped in the pleural cavity compromises cardiopulmonary function. Immediate temporary decompression is required to prevent cardiac arrest. This is commonly done by inserting a needle and cannula, usually used for intravenous access, through the chest wall into the pleural cavity (needle thoracostomy). The needle is withdrawn, and the cannula left in place to allow the trapped air to flow out. New blood control (closed system) intravenous cannulas are increasingly used in the NHS; at least 130 trusts bought a total of three million of them in the last year. They look very similar to both traditional and standard safety cannula (with needle guard or shield) but have an extra integral septum which closes when the needle is withdrawn and stops free flow in or out of the cannula. Flow is only possible once an intravenous line or Luer-lock syringe is attached to the hub, which opens the septum. Blood control (closed system) cannulas help prevent blood spillage, exposure and contamination, when used for their intended intravenous purpose, but they cannot be used to decompress a pneumothorax without additional equipment. The main patient safety risks are: staff may select a blood control (closed system) cannula not realising its limitations for this procedure a blood control (closed system) cannula may wrongly be assumed to be functioning in a patient who is deteriorating rapidly a second needle might be introduced risking very significant damage to the lung as it reinflates.

Sharps injuries (SI) and mucocutaneous exposures (MCE), collectively termed “blood and body fluid exposure” (BBFE), pose a diseases-transmission risk and a psychological stress to health care workers and a responsibility on employers to prevent their occurrence. However, little UK national data is published on their incidence.  The Royal College of Nursing (RCN) present results from a survey of their members.