WEEKLY NEWS FROM THE BMJ

WEEKLY NEWS FROM THE BMJ

This week in The BMJ 27 April 2018 Better care for patients with cancer For many people, cancer is now survivable and has become a long term condition. This week our clinical update reminds us to think about the psychological impact for the growing number of people living with cancer (doi:). As Alexandra Pitman and colleagues... Fiona Godlee Race played no part in Bawa-Garba decision, says GMC The UK General Medical Council’s decision to remove Hadiza Bawa-Garba from the UK medical register was in no way influenced by her race or sex, its chief executive has told The BMJ. Abi Rimmer Women see no benefit from colorectal cancer screening, study finds A single screening test using flexible sigmoidoscopy reduced colorectal cancer incidence and mortality in men but had little or no effect in women, a large randomised controlled trial in Norway has shown. Jacqui Wise Seven days in medicine: 18-24 April 2018 Sixty seconds on . . . the WannaCry cyberattack Although the NHS has learnt lessons from the WannaCry cyberattack on 12 May 2017, trusts need to do more to improve cybersecurity and introduce strategies to take action quickly “when, and not if, there is a further attack.” This was the conclusion of... Susan Mayor Junior doctors lose legal test case over right to have breaks every four hours Junior doctors have lost a High Court test case backed by the BMA over their right to have a 30 minute break every four hours or be paid at a higher rate. Clare Dyer NHS failed to communicate feeding advice to refugee mother, court rules The NHS will have to pay millions of pounds in compensation after a baby was left severely brain damaged because his mother, a refugee, could not understand English. Clare Dyer Collaborative procurement: five minutes with . . . Des Breen The NHS medical director discusses how closer collaboration between seven hospitals helped them save millions on products they use everyday Abi Rimmer NHS hospital drug costs are set to surpass spending in primary care An explosive growth in hospital drug spending is set to overturn the longstanding pattern of the NHS medicine budget, Nigel Hawkes reports Nigel Hawkes Treatment for those with multiple serious illnesses is “ineffective,” warns major review Medicine is poorly equipped to treat people that develop multiple chronic diseases concurrently, and must commit more resources to improving their treatment, a major global report has said. Nigel Hawkes Poorly performing general practices are more likely to prescribe homeopathy General practices in England with the worst prescribing quality scores are more than twice as likely to prescribe homeopathy than those with the best prescribing scores, a study has shown. Gareth Iacobucci Anger as Alfie’s Army protests outside Alder Hey Crowds, rallied by social media postings, try to storm Alder Hey children’s hospital in Liverpool on Monday 23 April, after the parents of Alfie Evans lost a “last ditch” appeal against ending life support for their nearly 2 year old son. Alison Shepherd The rise of ambiguous competing interest declarations Terms such as “unpaid consultancy” should be consigned to the dustbin Barbara Mintzes, Quinn Grundy Clarifying the roles of patients in research Common misunderstandings are a barrier to real progress Kristin Liabo, Kate Boddy et al Should we recommend e-cigarettes to help smokers quit? Smokers want to vape, it can help them quit, and it’s less harmful than smoking, say Paul Aveyard and Deborah Arnott. But Kenneth C Johnson argues that smokers who vape are generally less likely to quit and is concerned about youth vaping as a gateway... Paul Aveyard, Deborah Arnott et al How data protection changes will affect your practice Matthew Limb provides a quick guide to the new responsibilities for GPs and medical researchers after next month’s law change Matthew Limb Fentanyl misuse in the UK: will we see a surge in deaths? The US epidemic of overdose caused by the synthetic opioid could replay here, some commentators have suggested. Ingrid Torjesen investigates Ingrid Torjesen Email continues below advert RESEARCH UPDATE Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study Laila Staerk, Biqi Wang et al Age and sex of surgeons and mortality of older surgical patients: observational study Yusuke Tsugawa, Anupam B Jena et al Links between age and sex of surgeons and patients’ outcomes Natalie Coburn, Christopher J D Wallis et al Anticholinergic drugs and risk of dementia: case-control study Kathryn Richardson, Chris Fox et al COMMENT Margaret McCartney: AI in medicine must be rigorously tested Patience for patients David Oliver: Tube feeding and deteriorating patients—guidelines can take us only so far Doctors need to give up professional protectionism Narrow terms of reference mean that Jeremy Hunt’s review of gross negligence manslaughter will miss the point NEWS 2 sepsis score is not validated in primary care Effectiveness of antidepressants—should we rethink treatment duration? Mobile phone sign of degenerative cervical myelopathy Arm and leg reflexes in degenerative cervical myelopathy Author’s reply to Williams and Rowe The 100 000 Genomes Project: bringing whole genome sequencing to the NHS Obituary: David Delvin: GMC rebel and bestselling author EDUCATION Exploring low mood in a person with cancer A 54 year old man asks his doctor for a sleeping tablet. He has recently been diagnosed with a Dukes B adenocarcinoma of the rectum and seems low in mood. Although he has been given a good prognosis, has completed neoadjuvant chemotherapy, and is booked... Depression and anxiety in patients with cancer Advances in cancer treatments mean that half of people now diagnosed with cancer can expect to survive for at least 10 years, defining many cancers as long term conditions. Psychiatric illnesses such as depression and anxiety are common, but often neglected,... Recurrent haemoptysis in a child with advanced cystic fibrosis lung disease A 12 year old boy with cystic fibrosis has advanced lung disease (FEV 30%-40% predicted) and needs monthly intravenous antibiotics given through an implanted venous access device (visible in the radiograph in ). He has experienced recurrent life threatening... Finger metastasis from renal cell carcinoma An 83 year old woman presented with painful swelling of the left third finger following minimal trauma. Six months earlier she had noticed spontaneous ecchymosis at the same fingertip. Her medical history included a nephrectomy for metastatic renal cell... Smart monitoring . . . and other stories Smartwatches use photoplethysmographic sensors to measure heart rate. Analysed by a neural network, the same data can be used to identify atrial fibrillation. At the moment, the investigators are calling it proof-of-concept, but it might not be long... CAREERS Lucy Kalanithi: Work, life, grief, love Jobs for you from BMJ Careers   Drivers Medical Panel Member / Chair     Nationwide     Drivers Medical Panel Member / Chair     Nationwide     Clinical Lecturer in Physician Associate Studies     Hertford, Hertfordshire     Clinical Lecturer     Warwick, Warwickshire     Consultant in Public Health     Welwyn Garden City, Hertfordshire     More jobs ▶

Go to bmj.com Follow us on:

Forward to a friend Update your details Manage your emails

If you do not wish to receive these emails in future please unsubscribe here. Your unsubscribe request may take up to five working days to process. BMJ advances healthcare worldwide by sharing knowledge and expertise to improve experiences, outcomes and value. Visit bmj.com/company. The recipient should check this email and any attachments for viruses and malware as to the fullest extent permitted by law BMJ accepts no liability for any damage caused by viruses or malware. Emails sent or received by BMJ may be monitored for size, traffic, distribution and content. Use of our content is governed by any licence agreement entered into and our website terms and conditions.BMJ Publishing Group Limited trading as BMJ. A private limited company, registered in England and Wales under registration number 03102371. Registered office: BMA House, Tavistock Square, London WC1H 9JR, UK.

New and updated procedures added to ClinicalSkills.net

From ClinicalSkills.net:

We have a bumper crop of new procedures and updates for you this week!

The first two new procedures are on obtaining a sample for arterial blood gas measurement. One covers taking the sample via an arterial line, and the other shows taking the sample via an arterial puncture. Both procedures are by Claire Walker, Lecturer at the University of Liverpool. You'll find them in the Adults section, under the Observations category.

Obtaining a sample for arterial blood gas measurement via an arterial puncture

This procedure covers the reasons why arterial blood gas measurement may be carried out and the sites where an arterial puncture may be performed. It reviews the contraindications for carrying out the procedure, and what complications may follow. It describes how to perform the Allen test, to check the blood circulation to the hand. This procedure goes on to show the injection of local anaesthetic, how to take the blood sample and how to prepare the syringe of blood once the sample has been obtained.

Obtaining a sample for arterial blood gas measurement via an arterial line

The companion procedure shows how to collect the sample for arterial blood gas measurement from a patient who already has an arterial line in place. It emphasises the need to clearly identify an arterial line, and to check the 0.9% sodium chloride infusion used to maintain the patency of the arterial line before administration and at regular intervals. The sample must be taken at least 15 or 20 minutes after altering the patient's oxygen flow rate (or applying oxygen or suctioning), in order to reflect the patient's response to oxygen therapy.

Having described how to cleanse the sampling port on the arterial line and fill the "waste" syringe, the procedure shows how to take the sample, prepare the syringe of blood, and then flush the sampling port. It also covers the important observations that must be done following the procedure.

Other new procedures and updates are as follows:

Assisting with eating and drinking in a care home setting

This new procedure is an adapted version of "Assisting a patient with eating and drinking" that has been edited to be suitable for HCAs working outside of the hospital setting. The editor is Vickie Wylde, Regional Support Manager at Brighterkind Homes. It includes much advice specific to staff in care homes, but which is generally applicable in the community setting. The last two pages include a checklist and assessor questions, which can be downloaded separately.

Mouth Care

This has been peer reviewed and extensively revised by the author, with updated illustrations. It now includes reference to the Health Education England programme to improve oral health, "Mouth Care Matters". It also mentions the Sunflower Initiative to help staff identify those patients with dentures, to ensure that they get appropriate help with cleaning their dentures and try to prevent these getting mislaid.

Urine testing-HCAs

These two new procedures aimed at HCAs have been adapted from the Adults procedures on Urine observation and Urinalysis. You will find a checklist and assessor questions on both procedures at the end of the one on urinalysis.

Care of a PEG tube and Feeding via a PEG (bolus and pump feeding) Both of these Adults procedures have been updated and feature ENFIT connectors.

Washing a patient's hair in bed

This procedure, in the Adults category, has been updated and the illustrations refreshed, in line with the HCA version that was published in December 2017. 

Access these new procedures via the Library resources intranet page when on a Trust PC or off-site at www.clinicalskills.net with an OpenAthens account

Onexamination codes for MTW trainees

Calling All Doctors!                                         

Are you taking one of the following exams soon?:

DCH
DRCOG
First FRCR Physics
FRCA Final
FRCA Primary
FRCS General Surgery
FRCS Trauma and Orthopaedic Surgery
GP ST Stage 2 Knowledge Test/ Specialty Recruitment
MRCGP

MRCOG Part 1
MRCOG Part 2
MRCP Part 1
MRCP Part 2 Written

MRCPCH Foundation of Practice
MRCPCH Foundation of Practice and Theory and Science of Practice
MRCPCH Part 2

MRCPCH Theory and Science of Practice

MRCPsych Paper 1

MRCPsych Paper 2

MRCS Part A Papers 1 and 2
Specialty Certificate Examination in Acute Medicine
Specialty Certificate Examination in Endocrinology and Diabetes
Specialty Certificate Examination in Gastroenterology

The Library Service offers Onexamination revision codes from BMJ to help you pass your exams. Visit either site Library to register for an Onexamination account for 4 months revision.

Tunbridge Wells Hospital Library, Education and Training Centre

Maidstone Hospital Library, Academic Centre

Maidstone & Tunbridge Wells NHS Trust Library and Knowledge Services:

 web:

http://www.mtw.nhs.uk/library

blog:

mtwlibrary.blogspot.com

email:

mtw-tr.library@nhs.net

online catalogue

www.southeastlibrarysearch.nhs.uk