Gastrointestinal decontamination in the acutely poisoned patient

ObjectiveTo define the role of gastrointestinal (GI) decontamination of the poisoned patient.Data sourcesA computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.Study selection and data extractionClinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient.Data synthesisThe literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis, animal studies or small case series, and rarely based on randomized clinical trials.ConclusionsThe current literature supports limited use of GI decontamination of the poisoned patient

Towards a reframing of student support: a case study approach

© 2017, Springer Science+Business Media Dordrecht. This paper reports on a study that investigated the range of institutional support needs of international students at one Australian university with a view to increasing understanding of their needs and the ways in which support was provided. The study involved a number of data collection methods including focus groups, key informant interviews and a larger scale survey, undertaken in an inductive and sequential process. The results indicated that the levels of awareness about services differed, that lack of knowledge of how to access a service and finding information about it were key reasons for non-use, and that the helpfulness of staff impacted on the perception of services as useful. The paper concludes by recommending a reconsideration of current practices to move towards a model of student support service provision in which the student is at the centre