The decline of clinical contact in medicine.

Patient contact with medical students and clinicians may be on the decline. Increasing medical graduate numbers, workforce and training demands, and the institution of safe working hours are putting pressure on opportunities for direct clinical interaction. Medical education curricula and clinical postgraduate education supervisors must ensure that students and junior doctors recognise the importance of hands-on clinical contact with patients.

Clinical supervision by consultants in teaching hospitals.

Clinical supervision is a vital part of postgraduate medical education. Without it, trainees may not learn effectively from their experiences; this may lead to acceptance by registrars and junior doctors of lower standards of care. Currently, supervision is provided by consultants to registrars and junior doctors, and by registrars to junior doctors.

Inpatient mortality as related to triage category in three New South Wales regional base hospitals.

Objective: To establish the incidence of death after admission via the ED for each of the five categories of the Australasian Triage Scale in three New South Wales base hospitals, and to compare this with published data from an adult tertiary referral hospital in Victoria. To examine the causes of death in each category.

Methods: Information was collected from databases established as part of quality assurance projects at three New South Wales rural base hospitals from 1 January 2000 to 31 December 2000.

Integrated critical care: an approach to specialist cover for critical care in the rural setting.

Critical care encompasses elements of emergency medicine, anaesthesia, intensive care, acute internal medicine, postsurgical care, trauma management, and retrieval. In metropolitan teaching hospitals these elements are often distinct, with individual specialists providing discrete services. This may not be possible in rural centres, where specialist numbers are smaller and recruitment and retention more difficult.

Non-invasive positive pressure ventilation in patients with acute respiratory failure.

Non-invasive positive pressure ventilation is an emerging modality in contemporary critical care practice. Perhaps the most widely utilized and familiar form of non-invasive positive pressure ventilation is mask continuous positive airway pressure. Other common modes include mask Bi-level positive airway pressure and mask pressure support ventilation.