Intended for healthcare professionals



BMJ 2010; 340 doi: (Published 09 March 2010) Cite this as: BMJ 2010;340:c1285

In a medical emergency it’s not just doctors who have to make quick, safe decisions; patients too must have the capacity to make appropriate choices. A mnemonic used by doctors in one unit to recall the criteria for assessing decision making capacity is described in Chest (2010;137:421-7, doi:10.1378/chest.09-1133). CURVES stands for Choose and Communicate, Understand, Reason, Value, Emergency, Surrogate. The authors say this memory aid not only helps them make quick decisions about giving treatment during emergencies, but also helps them document the decisions they make.

When conservative treatment fails for patients who experience chronic pain in the coccyx when sitting or defecating, removing the coccyx is an option. Whatever the cause of the coccydynia, and whatever shows up or not on radiological investigations, coccygectomy can be helpful. Of 41 Danish patients who underwent the operation in one centre between 1993 and 2008, 33 reported excellent or good results and eight reported moderate or …

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