Utility and prevalence of imaging for underlying cancer in unprovoked pulmonary embolism

Current guidelines state that patients over 40 years of age with a first unprovoked pulmonary embolism should be offered limited screening for possible cancer and considered for intensive screening (abdomino-pelvic computed tomography and mammography), despite no evidence for the latter. The aim of this study was to evaluate the clinical utility and cost of intensive screening in routine clinical practice.

Implementing Surviving Sepsis guidelines in a district general hospital

We describe efforts made at Blackpool Victoria Hospital to implement the well-established international Surviving Sepsis guidelines. These included posters, pocket guides and stickers inserted in patient notes. All doctors and nurses in acute areas received specific information and education. Sepsis teams comprising both doctors and nurses were formed to encourage implementation and to audit and disseminate data. Data collection occurred from February to November 2009. Cases were considered prospectively at the time of initial

Update on cardiopulmonary resuscitation

Adult cardiopulmonary resuscitation (CPR) has been shown to improve survival for individuals suffering cardiac arrest. Despite this, the delivery of basic life support to victims outside the clinical environment remains poor, particularly as only a minority receive resuscitation. In addition, research continues to examine the optimal techniques for CPR and guidelines have been modified to reflect the latest developments. These guidelines are a compromise between simplicity and effectiveness.

Implementing Surviving Sepsis guidelines in a district general hospital

We describe efforts made at Blackpool Victoria Hospital to implement the well-established international Surviving Sepsis guidelines. These included posters, pocket guides and stickers inserted in patient notes. All doctors and nurses in acute areas received specific information and education. Sepsis teams comprising both doctors and nurses were formed to encourage implementation and to audit and disseminate data. Data collection occurred from February to November 2009.

Observing the NICEties of hypertension management

This review is based on presentations given at the Symposium of the High Blood Pressure Foundation supported by RCPE on 23 November 2011.National Institute for Health and Clinical Excellence guidance for the clinical management of hypertension, published last year, proposes a step change in UK clinical practice.1 Although broadly helpful, there are some concerns about its implementation. Ambulatory blood pressure monitoring for diagnosis of hypertension, though logical, will place an additional financial burden on primary care at a time of austerity.

Intravenous fluid use in the acutely unwell adult medical inpatient: improving practice through a clinical audit process

Background: Our Trust developed a clinical guideline to improve the prescribing and use of intravenous (IV) fluids based on the British consensus guidelines on IV fluid therapy for adult surgical patients. We audited the effect of targeted interventions to improve performance against this guideline.