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BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7181.474 (Published 13 February 1999) Cite this as: BMJ 1999;318:474

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Health professionals are notoriously slack at washing their hands between patients, and Swiss researchers report that doctors are worse than most (Annals of Internal Medicine 1999;130:126-30). An observational study at a teaching hospital in Geneva found that a range of health workers washed their hands about half as often as they should have. Hand washing was particularly poor at busy times of day and in the intensive care unit. The authors say that the time has come for serious organisational change to combat the problem. Targeting individuals doesn't seem to work.

Anaesthetists go to great lengths to prevent stomach contents backtracking up the oesophagus and into the lungs, so gastric aspiration is rare in adults. It is also rare in children, at least at the Mayo Clinic in the United States (Anesthesiology 1999;90:66-71). In a series of over 56000 children having surgery, only 24had perioperative aspiration and only nine developed respiratory symptoms. Three children needed ventilatory support, but there were no deaths. Most of the children with aspiration had emergency surgery.

The World Bank estimates that investing only $2 a head would cut maternal mortality in the developing world by half, but in the meantime women continue to …

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