This paper reviews the current evidence available on the practice of spinal immobilisation in the prehospital environment. Following this, initial conclusions from a consensus meeting held by the Faculty of Pre-hospital Care, Royal College of Surgeons of Edinburgh in March 2012 are presented.

Acute pain is every health care worker's responsibility, a key area of clinical management and one of Surgeon General's four focus points for improving quality of life after battlefield injury. The evolving practice of acute pain management requires an informed multidisciplinary and multimodal therapeutic approach to minimise each individual patient's experience of pain. Whilst subject matter experts progress the policies, protocols and capabilities associated with pain management, it remains the duty of every clinician, nurse, health care support worker and all Professions Allied to medicine (PAMs) to keep updated and maintain capability in this key area of clinical management.

Cofiicid was administered iutafnuscularly 1 h before open-heart surgery to seyenk2tlents in doses Af 1 gaich and to s1x'pdtients in doses of 2 ' ea;h. Cef*ia cooiicentrations wpre m ured in the right atrial biopsy ap in serum at onset ofsurSry, at time otatriE-biopsy, 15 mim after starting cardiopulmonary bypass, and at completion of cardiopulmonary bypass. Concentrations in the atrial biopsy and in serum at all periods exceeded the minimal inhibitory concentrations for organisms most frequently responsible for postoperative infections.Cefonicid (Monocid), a new broad-spectrum, long-acting, semisynthetic cephalosporin, has. exhibited protective activity against a number of experimental animal infections (1, 5) and is currently being evaluated in various clinical situations. The above qualities, coupled with a low toxicity (7), suggest that this agent might be useful as a prophylactic in open-heart surgery. The current study is concerned with an issue central to such use, the capacity of cefonicid to penetrate heart tissue.Thirteen adult patients scheduled for cardiac surgery were included in this study ( Preparation of tissues and assays was carried out by procedures described previously (8). Tissues were rinsed with water to eliminate contaminating blood, blotted dry, weighed, ground in a Ten-Broeck homogenizer containing about 10 mg of glass beads (100 pm in diameter), and extracted for 1 h with 1 ml of pH 6 buffer (minimum, 0.75 ml) per g at 4C. Standards for assay of serum samples were diluted in background-free normal human serum, and those for tissue assays were diluted in 1% pH 6 phosphate buffer.Cefonicid concentrations in serum and homogenate of atrial appendage were measured by disk agar diffusion assay with penicillin assay seed agar prepared in 1% pH 6

No abstract

No abstract