Case report: use of topical tranexamic acid to stop localised bleeding.

A case is presented in which topical tranexamic acid was used to stop local bleeding from a nipple following piercing in a young man with haemophilia. This case, with a review of the relevant literature, highlights the use of topical tranexamic acid as part of a methodical approach to stop localised, non-massive bleeding, particularly in patients with inherited or acquired coagulopathies.

Emergency department board rounds: are they worthwhile?

Objective: To determine whether daily board rounds in the emergency department (ED) alter patient management and whether they provide educational opportunities.

Method: A prospective observational study of board rounds conducted in a small to medium-sized ED in the United Kingdom. Data were collected on changes made and educational events that took place.

What is the value of ENT specialist outreach clinics?

Ear, nose and throat (ENT) specialist outreach clinics, in which hospital-based consultants hold clinics in general practice surgeries, have been popular with general practitioners (GPs) and patients. This prospective study recorded data on 1155 consecutive patients seen by one ENT surgeon in two GP surgeries. At each consultation, a record was kept of the requirement for further investigations that would normally be done at the same time as the consultation in a hospital department.

General practitioner outpatient referrals: do good doctors refer more patients to hospital?

Objective: To investigate the relation between general practitioners' referral rates to individual specialties and the individual areas of expertise of the referring doctors.

Design: Data collected on referral patterns in one group practice over nine months.

Setting: General practice in suburban Birmingham consisting of five partners and a trainee.