Ugeskrift for laeger
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The Danish health care system is undergoing a major reorganisation, resulting in fewer emergency departments (ED) with consultants in attendance 24/7. This questionnaire-based study evaluates the status of the reorganisation with emphasis on physician attendance and recruitment. 76% of the EDs are not staffed by consultants 24/7, 51% report difficulties in recruiting qualified personnel and 33% report problems connected to retaining them. 71% believe that a specialty in emergency medicine could help solve these problems. Danish EDs do not comply with the visions of the reorganisation plan.
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Palliative care strives to improve the quality of life of patients and their families facing the problems associated with life-threatening illness. In the cancer trajectory early multidisciplinary intervention achieving symptom control seems rewarding in terms of improving quality of life and even survival. Palliative care in non-malignant diseases is still an unexplored area. In palliative care the symptom pain is by far the most well investigated symptom and opioids constitute the cornerstone in its treatment, although the consequences of long-term treatment is still under investigation.
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We describe a formerly healthy 13-year-old boy who was admitted with symptoms of epiphora from his left eye over a period of four days and of left-sided peripheral facial palsy for one day. There was no history of trauma or tick bites. Cutaneous vesicles were observed in the ipsilateral ear. ⋯ A magnetic resonance imaging confirmed neuritis of the left facial nerve. The patient was treated with a combination of aciclovir and prednisolone for ten days. On follow-up one week later, full recovery had been obtained.
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Medical emergency teams (MET) are established at several Danish hospitals. We report experiences from 2010-2011 at a university hospital with 73,360 admissions in 2011. MET is activated less than expected as a systematic track and trigger system is not implemented yet. ⋯ MET have an important role of limitations of therapy or do not resuscitate orders in patients with critical irreversible illness. One in five patients seen by MET were admitted to the intensive care unit. Currently the Capital Region of Denmark covering 12 hospitals is implementing a full rapid response system at all hospitals.