A Nottingham team hoped to find a significant reduction in falls after second eye cataract surgery among elderly women. However, their randomised controlled trial allocated patients to fast-track or routine surgery, and an unexpected and dramatic reduction in waiting times meant they had to stop the study early on ethical grounds. The number of patients included in the final analysis was too small to analyse the impact of second eye surgery on falls, but it did improve visual disability and confidence (Age and Ageing 2006;35: 66-71).

It's not just a question of which design is best, when it comes to the tools of the trade. A survey of four face masks used for bag-mask ventilation revealed a great variation in performance and satisfaction between designs and the anaesthetists testing them out. Rather than identifying the “best buy,” the authors suggest a range of masks be available for emergency use (European Journal of Anaesthesiology 2006;23: 169-72).

Modafinil has recently been approved for the treatment of sleep disorders in shift workers, so what better group of people to test it on than shift working emergency physicians? Unfortunately, while the drug increased some aspects of cognitive function and subjectively improved the doctors' ability to attend handover sessions after their shift, it also made it more difficult …