Publications

Avoiding the pitfalls of Dr David Moor & Dr Howard Martin

Good management and care of patients who are dying requires the appropriate selection of physical, psychological and pharmaceutical support. Symptom relief frequently requires the use of opioids, including morphine. Side effects of opiates and other drugs may shorten life. Recent controversies (Drs. Shipman, Moor & Martin) have focussed attention on the use of opiates to cause or to accelerate death. The article provides a checklist which covers decision making processes, professional and patient consultation, conflict of interest, the environment, the choice of drug for symptom relief. It introduces the concept of the "palliative cushion" to a framework to assist in choosing the most appropriate medication for the management of dying patients. The appropriate use of analgesics (morphine, diamorphine), sedatives (diazepam, lorazepam) and euphoric agents (diamorphine) is discussed. Anaesthetic agents (e.g. propofol) and pure analgesics are not considered to have a useful place on the cushion. The cushion allows new or novel agents to be measured against the current standard.

PG Lawler FRCP,   FRCP(E), FRCA, Medical Director. Iodem Health

Implications for other surgical and medical interventions.

Concerns about poor outcome following plastic and aesthetic procedures has led the Chief Medical officer to provide a checklist for patients who are considering surgery. The article discusses how Sir Liam's checklist covering quality assurance for plastic surgery can be developed for routine surgical practice. The article includes an enhanced and comprehensive checklist which provides patients, Clinical Directors, risk managers and Chief Executives with a simple grid which can assist in ensuring that routine NHS surgery, surgeons, anaesthetists and back up facilities are safe and effective.

PG Lawler FRCP,   FRCP(E), FRCA, Medical Director. Iodem Health

Iodem Health attends the 2006 BAMM Conference, Liverpool.

FAQ's from the BAMM Conference