Practitioner CPD prompts
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A hundred years ago
24 Oct 2016
Some years ago, a practitioner sent for me to attend to a case of placenta praevia in which haemorrhage had recurred. When I arrived, she was almost in extremis, with a pulse of 160, and severe bleeding. The placenta was presenting and bulging into the vagina. I turned, left the breech plugging the lower uterine segment, and proceeded to transfuse her, but she sank and died quickly. I do not think anything could have saved her. This case left on my mind a deep impression of the perilous condition of a patient who has had one severe flooding due to placenta praevia. This is just the sort of case in which Caesarean section may help us to save mother and child.
Weigh up risks and benefits of buprenorphine and methadone
01 Oct 2009
Buprenorphine is safer during induction than methadone and, despite shorter retention in treatment, is not associated with a higher risk of death, a study from New South Wales has found. 'While treatment with methadone has been shown to reduce overall mortality in heroin users, both the early weeks of treatment and the period immediately after leaving treatment are associated with increased risk of death. Buprenorphine has been shown to be a safer option in some small studies.'