The extraction ratio was linearly related to time, and ranged 0.46-0.02. The peak clearance was 69 mL/min. Cartridge saturation was defined as a clearance that was equal to an estimate of the patient's intrinsic clearance. In our patient, this was equivalent to an extraction ratio of 0.2 at a flow rate of 150 mL/min. By this definition, cartridge saturation appeared to occur at 7 hours. Charcoal hemoperfusion was associated with a significant reduction in the apparent half-life, which is most easily explained by clearance from the central vascular compartment, during a prolonged absorptive phase. The patient made full recovery without evidence of neurological deficit.

The limited consultant supervision and small numbers of NCHDs in training for A&E medicine raise concerns about staffing. Most hospitals want GPs to work in their A&E departments. This has implications for training and for the interface between general practice and the A & E department.

Objectives: Our intention was to develop a meta-understanding of the ‘human aspects’ of providing palliative care. Integral to developing this meta-understanding was recognising the individuality of people, their varied involvements, situations, understandings, and responses, and the difficulty in stepping back to get a whole view of this while being in the midst of providing palliative care. We intended for this meta-understanding to inform reflections and sense-making conversations related to people’s changing situations and diverse needs. Methods: Using collaborative inquiry, this qualitative research was undertaken ‘with’ clinicians rather than ‘on’ them. Our team ( n = 7) was composed of palliative care clinicians and researchers from a co-located rural health service and university. We explored our personal perceptions and experiences through a series of 12 meetings over 8 months. In addition, through five focus groups, we acccessed perceptions and experiences of 13 purposively sampled participants with a range of roles as carers and/or healthcare providers. Data were dialogically and iteratively interpreted. Findings: Our meta-understanding of ‘human aspects’ of providing palliative care, represented diagrammatically in a model, is composed of ATTRIBUTES OF HUMANITY and ACTIONS OF CARING. ATTRIBUTES OF HUMANITY are death’s inevitability, suffering’s variability, compassion’s dynamic nature, and hope’s precariousness. ACTIONS OF CARING include recognising and responding, aligning expectations, valuing relationships, and using resources wisely. The meta-understanding is a framework to keep multiple complex concepts ‘in view’ as they interrelate with each other. Significance of findings: Our meta-understanding, highlighting ‘human aspects’ of providing palliative care, has scope to embrace complexity, uncertainty, and the interrelatedness of people in the midst of resourcing, requiring, and engaging in palliative care. Questions are posed for this purpose. The non-linear diagrammatic representation of ATTRIBUTES OF HUMANITY and ACTIONS OF CARING facilitates multiple ways of engaging and revisiting palliative care situations or navigating changes within and across them.

AimTo determine those factors which influence'trainees' attitudes to the practice of emergency medicine in rural areas.