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A series of short articles on key topics in perioperative medicine, published in the British Journal of Hospital Medicine

POM in a Nutshell

17

Shared decision making in perioperative medicine

Dr David Timbrell, St George's Hospital, London, UK; Dr Ramai Santhirapala, Guy’s and St Thomas’ Hospital, London, UK

01 April 2020

Shared decision making is a collaborative process between clinicians and patients, which aims to select the most suitable management option based on both best available evidence and patient preferences. This article looks at the role of shared decision making in perioperative medicine.

16

Beta blockers in the perioperative period

Dr Mark Prince, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

10 Feb 2020

The cardiovascular effects of beta blockers are widespread, so their use in the perioperative period ought to be beneficial, although this is not clear cut. This article discusses the evidence for and against the use of beta blockers perioperatively and gives guidance for best practice.

15

Perioperative anaemia and patient blood management

Dr Katie Samuel, ST7 Anaesthetist, Southmead Hospital, Bristol

10 Dec 2019

Anaemia is a common condition affecting approximately 30% of surgical patients, with iron deficiency being the leading cause (Musallam et al, 2011). The World Health Organization historically defined anaemia as a haemoglobin concentration of less than 120 g/litre for women and 130 g/litre for men. However, a more recent international consensus statement on management of perioperative anaemia has suggested using 130 g/litre for both men and women (Muñoz et al, 2017).

14

Enhanced recovery after obstetric surgery

Dr Sarah Ciechanowicz, ST7 anaesthetist, and Dr Nisa Patel, consultant anaesthetist, University College London Hospital

01 Oct 2019

Enhanced recovery is a multimodal package of care intended to expedite recovery following surgery. Many units now having enhanced recovery for obstetric surgery as a standard of practice for elective caesarean deliveries. Early discharge (after 24 hours) for uncomplicated caesarean delivery is in keeping with National Institute for Health and Care Excellence guidance.

13

Alcohol and anaesthesia

Dr Tom Blincoe, Consultant Anaesthetist, Department of Anaesthetics, Royal Cornwall Hospital, & Dr Duncan Chambler, Consultant in Anaesthesia and Intensive Care, Department of Anaesthetics, Dorset County Hospital

01 Sep 2019

Alcohol is the most commonly consumed recreational drug in the UK – 56% of adults drink alcohol regularly and nearly 10% drink on 5 or more days a week. 1.6 million adults in the UK may have some level of alcohol dependence (Office for National Statistics, 2017).

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