Learning disability awareness training for undergraduate midwifery students: Multi-method evaluation of a co-produced and co-delivered educational intervention in England.

Background: Midwives lack the confidence and competence to identify and support people with learning disabilities, putting this population at risk of inequitable maternity care.

Objectives: To co-produce, co-deliver and evaluate maternity focused learning disability awareness training for student midwives, in collaboration with experts-by-experience (people with learning disabilities).

Design: Multi-methods study evaluating the impact and acceptability of learning disability awareness training.

Malignant middle cerebral artery syndrome with thrombotic thrombocytopenia following vaccination against SARS-CoV-2.

Cases of thromboses at unusual sites with thrombocytopenia have been reported following vaccination against Sars-CoV-2. This new syndrome, christened vaccine-induced thrombotic thrombocytopenia (VITT), mainly results in venous thromboses. We report the case of a young woman with a right middle cerebral artery stroke following vaccination with ChAdOx1 nCoV-19.

Evaluation of Outcomes Among Patients With Traumatic Intracranial Hypertension Treated With Decompressive Craniectomy vs Standard Medical Care at 24 Months: A Secondary Analysis of the RESCUEicp Randomized Clinical Trial.

Importance: Trials often assess primary outcomes of traumatic brain injury at 6 months. Longer-term data are needed to assess outcomes for patients receiving surgical vs medical treatment for traumatic intracranial hypertension.

Objective: To evaluate 24-month outcomes for patients with traumatic intracranial hypertension treated with decompressive craniectomy or standard medical care.

Impacts of trait anxiety on visual working memory, as a function of task demand and situational stress.

Higher trait anxiety can impair cognitive functioning via attention, but relatively little is known about the impacts on visual working memory. These were investigated using previously validated visual feature binding tasks. In Study 1, participants' memory for visual features (shapes) and feature bindings (coloured shapes) was assessed.

Medical-legal partnerships: 11 years' experience of providing acute legal advice for critically ill patients and their families.

Background: Medical-legal partnerships integrate lawyers into health care to identify and address legal problems that can create and perpetuate disparities in health for patients and their families. They have previously been utilised for patients who are at high-risk of being disadvantaged such as the elderly, the disabled and those affected by chronic diseases. We have used a partnership to address the legal needs of patients with acute, critical illness including major trauma.

Guidelines for safe transfer of the brain-injured patient: trauma and stroke, 2019: Guidelines from the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society.

The location of care for many brain-injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury.

Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension.

Background: The effect of decompressive craniectomy on clinical outcomes in patients with refractory traumatic intracranial hypertension remains unclear.

Methods: From 2004 through 2014, we randomly assigned 408 patients, 10 to 65 years of age, with traumatic brain injury and refractory elevated intracranial pressure (>25 mm Hg) to undergo decompressive craniectomy or receive ongoing medical care. The primary outcome was the rating on the Extended Glasgow Outcome Scale (GOS-E) (an 8-point scale, ranging from death to "upper good recovery" [no injury-related problems]) at 6 months.

London Trauma Conference 2015 : London, UK, 8-11 December 2015.

I1: Trauma, Pre-hospital and Cardiac Arrest Care 2015 Pascale Avery, Leopold Salm, Flora Bird A1: Retrospective evaluation of HEMS ‘Direct to CT’ protocol Anja Hutchinson, Ashley Matthies, Anthony Hudson, Heather Jarman A2 Rush hour – Crush hour: temporal relationship of cyclist vs. HGV trauma admissions. A single site observational study Maria Bergman Nilsson, Tom Konig, Nigel Tai A3 Semiprone position endotracheal intubation during continuous cardiopulmonary resuscitation in drowned children with regurgitation: a case report and experimental manikin study Espen Fevang, Børge Hognestad, Håkon B.

The role of neurosciences intensive care in neurological conditions.

The neurosciences intensive care unit provides specialized medical and nursing care to both the neurosurgical and neurological patient. This second of two articles describes the role it plays in the management of patients with neurological conditions.

The role of neurosciences intensive care in trauma and neurosurgical conditions.

The creation of neurosciences intensive care units was born out of the awareness that a group of neurological and neurosurgical patients required specialized intensive medical and nursing care. This first of two articles describes the role of neurosciences intensive care in the management of trauma and neurosurgical conditions.

Extending access to specialist services: the impact of an onsite helipad and analysis of the first 100 flights.

Background: In November 2011, University Hospital Southampton (UHS), now a major trauma centre, opened its onsite helipad, allowing patients to be brought to the emergency department (ED) directly by air ambulance. Prior to this, helicopters were required to land at a local playing field and the patient had to be transferred by land ambulance. This study aims to investigate the impact this change in practice has had on the flow of patients to the ED.

Decompressive craniectomy for acute disseminated encephalomyelitis.

Background: Acute disseminated encephalomyelitis (ADEM) is a rare, acute demyelinating condition. Although it usually presents in an acute or subacute manner over days, its clinical course may be rapid with symptoms and signs of severe intracerebral mass effect secondary to cerebral oedema.

Methods: Case report and literature review.

Erroneous intracranial pressure measurements from simultaneous pressure monitoring and ventricular drainage catheters.

The objective of this report is to highlight the potential for false pressure measurements from systems that combine intracranial pressure (ICP) measurement and ventricular drainage. If the ports of the drain become blocked to the extent that they present a high resistance to cerebrospinal fluid flow, then a significant pressure gradient between the inside and outside of the catheter may be established. Thus, any intracatheter transducer will faithfully record a pressure much lower than true ICP.

High dose methylprednisolone in the immediate management of acute, blunt spinal cord injury: what is the current practice in emergency departments, spinal units, and neurosurgical units in the UK?

Background: The National Acute Spinal Cord Injuries Studies and the Cochrane Review advocate the administration of high dose methylprednisolone following acute traumatic spinal cord injury. However, controversy surrounds its use and approaches between different units are often inconsistent.

Methods: A questionnaire was sent to all emergency departments receiving major trauma and all specialist neurosurgical and spinal units in the UK to determine the current practice regarding the use of high dose methylprednisolone in the immediate management of acute, blunt spinal cord injuries.

Traumatic atlantoaxial rotatory subluxation.

Atlantoaxial rotatory subluxation should be considered in the presentation of traumatic torticollis. This case report discusses the characteristic radiographic findings and appropriate management.

Prediction of hyperkalemia in dogs from electrocardiographic parameters using an artificial neural network.

Objective: To predict severe hyperkalemia from single electrocardiogram (ECG) tracings.

Methods: Ten conditioned dogs each underwent this protocol three times: Under isoflurane anesthesia, 2 mEq/kg/hr of potassium chloride was given intravenously until P-waves were absent from the ECG and ventricular rates decreased > or =20% in < or =5 minutes. Serum potassium levels (K(+)) were measured at regular intervals with concurrent digital storage of lead II of the surface ECG.

Minimally invasive direct cardiac massage and defibrillation.

Direct massage of the heart may be performed using a specifically designed device inserted via a limited thoracic incision. The technique is simple to perform and has been shown in experimental studies to be physiologically similar to formal open-chest cardiac massage. Preliminary human studies have been encouraging and pre-hospital and in-hospital studies are in progress.

Hypertonic saline treatment of severe hyperkalemia in nonnephrectomized dogs.

Objectives: To determine whether a hypertonic saline bolus improves cardiac conduction or plasma potassium levels more than normal saline infusion within 15 minutes of treatment for severe hyperkalemia. Previously with this model, 8.4% sodium chloride (NaCl) and 8.

Use of tube condensation as an indicator of endotracheal tube placement.

Study Objective: To determine whether condensation on the inner surface of the endotracheal tube (vapor trail) is a reliable indicator of intratracheal placement.

Methods: Twenty-seven separate experiments were conducted on 10 conditioned, mongrel dogs weighing 15 to 20 kg each. After induction of anesthesia, an endotracheal tube was placed in the trachea under direct visualization.