Goals of patient care system change with video-based education increases rates of advance cardiopulmonary resuscitation decision-making and discussions in hospitalised rehabilitation patients.

Background: Advance cardiopulmonary resuscitation (CPR) discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR.

Aim: To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients.

Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making.

Background: Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions.

Methods: Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature.

Portal biliary ductopathy caused by cavernous transformation of the portal vein.

A 42-year-old woman presented with a 1-week history of epigastric pain and deranged liver function tests (LFTs) on a background of known portal vein thrombosis (PVT) with cavernous transformation. Imaging with ultrasound, CT and MR cholangiopancreatography demonstrated known PVT, with distortion of the common bile duct and a bulky head/proximal body of the pancreas, thought to be due to mass effect from cavernous transformation related to PVT. At endoscopic retrograde cholangiopancreatography, the common hepatic duct was noted to be smaller in diameter, without any filling defects or discrete strictures.