This article presents findings from a systematic literature review of whether blisters arising from minor burns should be de-roofed or left intact. It discusses the risks of infection, healing outcomes, discomfort, choice of dressings and costs associated with each method, and reveals that debriding blisters larger than the patient's little fingernail while leaving smaller ones intact is generally agreed to be the best option. The article also explains external factors that influence the choice of whether to debride or leave blisters intact, reviews policy at the trust where one of the authors works in the context of the research and makes recommendations for practice.
Pyrexia is the most common clinical complaint seen in children by healthcare professionals, yet many parents and professionals cannot recognise the condition and misunderstand antipyretic administration. This article explores the research on the use of antipyretics in children with fever, and compares concomitant and monotherapeutic methods of ibuprofen and paracetamol administration.
Paramedic's have verbalised uncertainty on how to proceed when treating unwell patients who refuse treatment, stating that they feel ill-equipped to interpret situations when patients refuse treatment. They expressed a need to be formally trained in how to systematically, yet quickly, assess a patient's capacity, rather than relying on intuition or opting out with the ‘take them to hospital’ approach, as they report it is better to face the accusation of assault or battery, than allegations of negligence. This article will explore the appropriate mechanisms and approach for the assessment of capacity in emergency situations. Capacity will be defined according to the Mental Capacity Act 2005 (c.9), with an explanation of consent and the particular difficulties faced by paramedics in the assessment of capacity in an emergency will be identified and analysed.
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