The pecking order.

This paper explores the idea that courtesy and respect between health professionals at each stage of the admission process of a patient to hospital would make life much easier and more pleasant for all staff.

A review of the evidence for and against thromboprophylaxis in total hip replacement.

Deep vein thrombosis (DVT) after an unprotected total hip replacement (THR) is common and this review explores the balance between risks and benefits of thrombo-prophylaxis in protecting patients undergoing THR. A literature search for English publications was conducted on Medline & PubMed. Governance bodies and their guidelines were consulted.

Routine spinal immobilization in trauma patients: what are the advantages and disadvantages?

Routine spinal immobilization for trauma patients has become established in developed countries throughout the world. Cervical spinal injury is, however, relatively rare in trauma patients, and immobilization practice was developed largely without firm supporting evidence. In recent years, published evidence has suggested that spinal immobilization may in some cases be harmful.

MEDCAPS--do they work?

The objectives of this paper are to lay out for wider discussion the potential advantages and disadvantages of active military units providing medical care for the local population through ad hoc clinics (MEDCAPS). The literature on this subject has been reviewed and the personal experience of MEDCAPS by the author and other doctors in Helmand Province 2007/8 is presented. Although in the published literature, MEDCAPS are almost universally regarded as being good for relations between the military and civilians, the reality on the ground is that they potentially risk the lives of both staff and patients.