BackgroundMedication review is recommended at asthma appointments. The presence of propellant in the metered dose inhalers (MDIs) makes it challenging to identify when the inhaler is empty. The COVID-19 pandemic has resulted in move towards more virtual monitoring of care. We aimed to evaluate if patients identify when the inhaler is empty and the method of inhaler disposal.MethodsProspective, multicentre quality improvement project. Data collected from children with asthma and other respiratory conditions.Outcome measuresChildren/carers attending hospital were asked how they identify an empty salbutamol inhaler; dose counters in the preventer inhalers and disposal practices were reviewed.Results157 patients recruited. 125 (73.5%) patients deemed an empty inhaler as either full/partially full. 12 of 66 (18.2%) preventer inhalers with a dose counter were empty. 83% disposed their inhalers in a dustbin.ConclusionsPatients cannot reliably identify when their MDI is empty. There is an urgent need for improving inhaler technology and providing appropriate guidance on how to identify when an MDI is empty.
ObjectiveTo review common presentation of oral ulcers in children and discuss management of symptoms and subsequent investigation.ConclusionAlthough a common presentation in children, diagnosis can be challenging. Thorough history taking is critical towards diagnosis and supports signposting to relevant specialities. Clinicians should be able to support first-line symptomatic management of oral ulceration.
cardiac arrest call'. Factor analysis revealed that the scale lacks construct validity however it demonstrated that students consistently appear less confident dealing with on-call tasks compared to day-today tasks. Discussion Simulation can provide experience useful for learning which is not necessarily provided by shadowing along. Pre-registration doctors' confidence appears to be higher in tasks felt to be day-today for junior doctors and less in oncall tasks. They also grouped items in a third category: dealing with difficult situations. Simulation increased the confidence in all areas and brought the item included in the latter category into alignment with day-today tasks. Factor analysis has a number of weaknesses but this should be considered a useful tool in the evaluation of simulation programmes of any size. Conclusions Simulation, in addition to standard assistantship placements, can provide a further increase in confidence in tasks associated with being a junior doctor and can provide experiential learning not otherwise acquired. Recommendations Simulation programmes should be incorporated into assistantship placements and statistical methods of evaluation should be considered when designing programme of any size.
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