Counting the cost.

In his 'practical guide for improving communication and getting what you want in your relationships', best selling author John Gray argues that 'men are from Mars, women are from Venus'.

The quiet servant.

Chaplains have been involved in health care for hundreds of years. St Bartholomew's Hospital, in London, for example, was founded in 1123 by Rahere, a favourite courtier of Henry I who had taken monastic vows and who became the first prior of the hospital, managing the monks who cared for its patients.

A practical guide to carrying out skin-prick allergy testing.

Skin-prick testing is one of the cheapest and most widely available methods for diagnosing allergies. With ever-increasing numbers of nurses performing the tests in nurse-led clinics, it is essential that the procedure is fully understood and carried out correctly, particularly in terms of patient safety. This article discusses the indications, contraindications, advantages and disadvantages of skin-prick testing and details how to carry out the procedure.

Cuffed endotracheal tube use in paediatric prehospital intubation: challenging the doctrine?

Questioning traditional doctrines is essential if patient care is to improve and progress. Historically accepted teaching is to use uncuffed tubes in all children up to puberty. This has been the practice in anaesthesia, intensive care and paediatric resuscitation both in and out of hospital.

Swallowing dysfunction in patients with unilateral vocal fold paralysis: aetiology and outcomes.

Although unilateral vocal fold palsy (UVFP) is a common problem, data relating to swallowing dysfunction are sparse. We reviewed the clinical findings (method of presentation, underlying diagnosis and position of the vocal folds) of 30 patients and conducted a follow-up telephone survey. Outcome measures used were direct visualization of fold function, position and compensation.

Evaluating the effect of setting up a nurse-led heart failure service.

In the UK 880,000 people have definite or probable chronic heart failure with 63,000 new cases being identified each year (Department of Health, 2003). Heart failure and its management have become a national and governmental priority. A specialist nurse was recruited to establish and manage a nurse-led service for this client group.

Aneurysmal subarachnoid haemorrhage in pregnancy.

Although uncommon, aneurysmal subarachnoid haemorrhage (SAH) in pregnancy can be devastating for both mother and baby. It is the leading cause of other indirect maternal death in England and Wales accounting for 60 deaths in the decade 1988-1999. No single obstetric or neurosurgical unit has sufficiently large database or experience in managing this condition in pregnancy.

Anaphylaxis from medroxyprogesterone acetate.

Background: More than 30 million women in more than 90 countries use depot medroxyprogesterone acetate as an injectable contraceptive agent, and it is thought to be very safe. However, it should be recognized that serious and potentially life-threatening adverse effects can occur.

Case: A 40-year-old para 2 went into anaphylactic shock after receiving 150 mg of depot medroxyprogesterone acetate intramuscularly.