Emmanuel E. Ajudua

Vaping is the inhaling of aerosolised heated liquids in e-cigarettes. It is now known that vaping is not as harmless as was previously described in the mid-2000s when the devices were introduced into the markets across Europe and America. The e-liquids are made of flavourings or psychoactive substances and may or may not contain nicotine. Research shows that these devices and the e-liquids have the potential for causing harm to humans. Although they were marketed originally to assist with breaking addiction to cigarette smoking and tobacco harm reduction, evidence suggests they are not entirely harmless. This continuing medical education article focuses on what is known and what remains unknown about e-cigarettes. Contribution: This CPD article shows that a lot remains unknown about e-cigarettes and their long-term effects on human health. Also, very little is known about the effect of second-hand exposure to the e-cigarette exhaled aerosol residue. In high-income countries, they are used commonly among adolescents and young adults. In recent years, research in South Africa shows an increasing pattern of use among adolescents and young adults. This raises concerns for potential health risks for this population and the need for research that describes the effectiveness of these devices in tobacco harm reduction and the potential risks of exposure in adolescents and young adults.

Shock is a clinical state where oxygen demand in the cells exceeds supply due to hypoperfusion. Early recognition of the patient with shock and a clear understanding of the possible underlying pathologies causing the shocked state aid in providing adequate interventions to mitigate the patient’s outcome and reduce the chances of morbidity and mortality. This article highlights the management of undifferentiated shock as it usually presents in primary care. It also provides information on the four main types of shock and provides a brief overview of the common underlying pathologies associated with each and highlights useful investigations that aid with early recognition and focused interventions to reverse shock. Contribution: This CPD article highlights important information for clinicians in the early identification of shock and immediate interventions in management of the shocked patient.