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Found 499 results
  1. News Article
    Death rates among seriously ill COVID-19 patients dropped sharply as doctors rejected the use of mechanical ventilators, analysis has found. The chances of dying in an intensive care unit (ICU) went from 43% before the pandemic peaked to 34% in the period after. In a report, the Intensive Care National Audit & Research Centre said that no new drugs nor changes to clinical guidelines were introduced in that period that could account for the improvement. However, the use of mechanical ventilators fell dramatically. Before the peak in admissions on 1 April, 75.9% of COVID-19 patients were intubated within 24 hours of getting to an ICU, a proportion which fell to 44.1% after the peak. Meanwhile, the proportion of ICU patients put on a ventilator at any point dropped 22 percentage points to 61% either side of the peak. Researchers suggested this could have been a result of “informal learning” among networks of doctors that patients on ventilators were faring worse than expected. Read full story Source: The Telegraph, 3 September 2020
  2. Content Article
    This easy read document, from Macintyre, should be used as an aid in helping people to: prepare for their appointment participate in the appointment understand the advice given at the appointment. It can also be presented to the health professional - by using information from One Page Profile, the document serves as an aid for the health professional on how to engage with the person during the appointment.
  3. Content Article
    This article from Petriceks and Schwartz, published in Palliative & Supportive Care, describes a four-element approach centered on Goals, Options, Opinions and Documentation that serves as an effective structure for clinicians to have conversations with patients and families to address care management when the path forward is unclear.
  4. Content Article
    Survive the wards with key information at your fingertips with this top rated app. It provides clear and succinct information to help UK Foundation doctors navigate some of the common clinical scenarios that they'll face on the wards.
  5. Content Article
    This article from Ashton et al. outlines how one health system in the United States sought to make antibody testing available to staff as a strategy to decrease anxiety and improve sense making around the crisis.
  6. Content Article
    'I am a junior doctor. It is 4 a.m. I have run arrest calls, treated life-threatening bleeding, held the hand of a young woman dying of cancer, scuttled down miles of dim corridors wanting to sob with sheer exhaustion, forgotten to eat, forgotten to drink, drawn on every fibre of strength that I possess to keep my patients safe from harm.' How does it feel to be spat out of medical school into a world of pain, loss and trauma that you feel wholly ill-equipped to handle? To be a medical novice who makes decisions which - if you get them wrong - might forever alter, or end, a person's life? To toughen up the hard way, through repeated exposure to life-and-death situations, until you are finally a match for them? In this heartfelt, deeply personal account of life as a junior doctor in today's health service, former television journalist turned doctor, Rachel Clarke, captures the extraordinary realities of ordinary life on the NHS front line. From the historic junior doctor strikes of 2016 to the 'humanitarian crisis' declared by the Red Cross, the overstretched health service is on the precipice, calling for junior doctors to draw on extraordinary reserves of what compelled them into medicine in the first place - and the value the NHS can least afford to lose - kindness.
  7. Content Article
    The aim of this study from H R Guly was to describe the injuries misdiagnosed as a sprain of the wrist and to determine the approximate incidence of misdiagnosis in patients diagnosed as having a sprain of the wrist. In total 57 injuries initially diagnosed as a sprained wrist had a different diagnosis (1.76% of all diagnoses of sprained wrists). This is an underestimate of the true incidence of diagnostic error. Forty two per cent of the misdiagnoses were of greenstick or torus fractures of the distal radius. Guly concluded that training for junior doctors in A&E departments should be improved—especially training in radiological interpretation. Other methods of preventing diagnostic errors by misreading of radiographs, for example, more hot reporting of radiographs by radiologists or radiographers should be considered.
  8. News Article
    Doctors who have been shielding during the covid-19 pandemic have said they are worried for their safety when they return to work. From 1 August those who are at high risk of serious illness if they contract covid-19 will no longer be advised to shield in England, Scotland, and Northern Ireland.123 But doctors who have been shielding during the pandemic have expressed concerns about their safety when they return to work, and say they feel forgotten by their employers. Read full story (paywalled) Source: BMJ, 21 July 2020
  9. Content Article
    The perspective of Megha Prasad, a New York cardiologist leading a COVID-19 infections disease service, discusses leadership qualities of being available, communication, adaptability, humility and gratitude as key to effective leadership during challenging times.
  10. Content Article
    The BMA sent out its first survey at the beginning of April. The most recent survey closed on 13 August and nearly 4,000 doctors took part.  The 13 August 2020 results found: 60% of doctors said they were not very, or not at all, confident in their local health economy managing demand as normal NHS services resume. Half of doctors said they were not very, or not at all, confident in being able to manage a second wave of COVID-19. 26% of doctors said that in the last two weeks non-Covid demand had increased to pre-pandemic levels, with 17% saying that demand is now even higher than it was before.
  11. News Article
    Regulators have uncovered multiple examples of patients being put at risk when junior doctors are left with tasks they are not trained for, lacking support, and facing bullying and inappropriate behaviour. Inspection teams have had to intervene – in some cases contacting senior trust staff – to ensure urgent issues are addressed, after the inspections. Health Education England oversees training nationally, which includes making the checks at trusts which have been put under “enhanced monitoring” by the professional regulator, the General Medical Council, because of concerns from trainees. HSJ has obtained and examined 20 reports, all produced since the beginning of 2019. Themes running through the reports included: Lack of support from consultants. Trainees struggled to contact consultants out of hours. Bullying and inappropriate behaviour was reported at several trusts. Inspectors found a reluctance to report concerns and/or a lack of knowledge of how to do it. Teaching was often of poor quality or cancelled – and sometimes trainees struggled to attend sessions because of how their shifts and rotations were scheduled. Trainees in several trusts reported IT problems, such as being locked out of systems so being unable to access clinical notes and blood tests, and IT systems taking up to 30 minutes to start up, sometimes delaying patient care. Read full story (paywalled) Source: HSJ, 29 June 2020
  12. News Article
    Dozens of hospitals are running short of scrubs in the latest problem to hit the NHS over the supply of personal protective equipment (PPE) during the coronavirus pandemic. The shortages are revealed in a survey of UK doctors undertaken by the Doctors’ Association UK (DAUK), which found that 61% said that the hospital where they worked was facing a shortage of scrubs. In recent months, many more NHS staff have begun wearing scrubs, which are usually used mainly by surgical staff, to protect themselves against COVID-19. The prevalence of coronavirus in hospitals has prompted many to switch from wearing their own clothes at work to using scrubs, and handing them in to be washed at the end of their shift. However, the big increase in demand for scrubs from doctors, nurses, physiotherapists and occupational therapists has left many hospitals unable to keep up and also put unprecedented pressure on hospital cleaning services. Some staff have even worn pyjamas intended for patients when scrubs have run out. “Protective clothing must be considered to be at a par with other PPE by Public Health England and must be provided to staff by the NHS," said said Dr Samantha Batt-Rawden, the president of the DAUK. She added: “A failure to adequately supply scrubs to staff may risk further community spread of Covid-19.” Read full story Source: The Guardian, 15 June 2020
  13. Content Article
    The BMA has provided clarification on PPE use in primary and secondary care, including procurement, use, safe working and CPR.
  14. News Article
    "I'm not sure I want to be a nurse anymore," she tells me. "I've seen more people die in the past two months than in the whole six years." Some 70% of health workers dealing with COVID-19 in Italy's hardest-hit areas are suffering from burnout, a recent study shows. "This is actually the hardest moment for doctors and nurses," says Serena Barello, the author of the study. Read story Source: BBC News, 26 May 2020
  15. Content Article
    Eleanor Balme and colleagues in this BMJ article discuss the findings of a review that they have undertaken into the need for, and potential of, resilience training in doctors.
  16. Content Article
    "Some weeks ago my main worries were around my GCSEs. Now I hear every day about deaths from COVID-19." Teenager Zoya Aziz's parents are both doctors. In this blog in the Guardian, she gives a frank account of her life at the moment and her fears.
  17. Content Article
    In part two of the BMJ Supportive and Palliative Care article, Dr Tavabie and Dr Ball explore the themes from frontline palliative care staff during the pandemic. In the time since their previous article, the news reports of escalating numbers of people dying from the virus, inadequate personal protective Equipment (PPE) provision and continued discussions of an impending ‘peak’ for the outbreak has painted a worrying picture. Further conversations with clinicians working to help patients dying from COVID-19 will hopefully provide readers with a diary and a window into the experiences of people working through the pandemic as the tide rises in the UK. Read part one of this article  
  18. Content Article
    Today we find ourselves in the middle of a pandemic. COVID-19 has swept across the globe with thousands dead, more seriously unwell, and a sense of anxiety and uncertainty within healthcare professions that is unlike anything we have seen. As the course of the viral illness becomes clearer, management guidelines are being produced, including around the topics of supportive and palliative care. To understand the real life implications of working on the front line, Dr Tavabie and Dr Ball, in this BMJ Supportive and Palliative Care article, conducted a series of short structured interviews with clinicians across the UK in a variety of healthcare settings, discussing their experiences and looking for themes arising from the current COVID-19 outbreak. They hope that quotes from these conversations make for an accurate description of our current time, and may be of interest now and in future. Read part two of the article
  19. Content Article
    Rosie Hughes has tested positive for the coronavirus that has killed so many of her patients. In her candid blog, published in the Guardian, she talks about her experiences, fear and the guilt she feels.
  20. Content Article
    This is the YouTube Channel for the UCSF School of Medicine in the USA. Here you are able to listen and watch webinars on the latest 'grand rounds' on COVID-19. These webinars cover: paediatrics shape of the pandemic, digital innovation epidemiology, science & clinical manifestations of COVID-19 research general updates.
  21. Content Article
    Recordings with frontline staff at Bradford Royal Infirmary, taking you behind the scenes on the wards as they plan for the onset of COVID-19 and then cope as the patients arrive.
  22. Content Article
    The Resuscitation Council UK issued guidance on how to manage a cardiac arrest in the COVID positive patient. Imperial College Hospital in conjunction with the Imperial College School for Medicine have produced this video to accompany the guidance and shows practically what the process is.
  23. Content Article
    "We talk about coronavirus all the time, but it’s often in terms of a bigger picture. I find it hard to make sense of that bigger picture from the frontline. In a crisis of scale I want to tell the story I’ve seen – the story of a pandemic unfolding one person at a time." A blog published in the Guardian by Shaan Sahota, a junior doctor working in London.
  24. Content Article
    This page provides a list of useful resources for healthcare staff who are working in intensive care units and critical care roles during the COVID-19 pandemic.
  25. News Article
    Frontline doctors have told the Independent they have been gagged from speaking out about shortages of protective equipment as they treat coronavirus patients – with some claiming managers have threatened their careers. Staff have been warned not to make any comments about shortages on social media, as well as avoiding talking to journalists, while NHS England has taken over the media operations for many NHS hospitals and staff. The Independent has seen a series of emails and messages warning staff not to speak to the media during the coronavirus outbreak. One GP has been barred from working in a community hospital in Ludlow after making comments about the lack of equipment, while another in London said they were told to remove protective equipment they had purchased themselves. NHS England confirmed it was controlling media communications, which it said was part of its national emergency incident planning to ensure the public received “clear and consistent information”. Read full story Source: The Independent, 1 April 2020
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