The journal of the Royal College of Physicians of Edinburgh
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J R Coll Physicians Edinb · Jun 2010
Mortality in out-of-hours emergency medical admissions--more than just a weekend effect.
Mortality among emergency medical admissions to hospital is higher for admissions at the weekend than on weekdays; this also holds true for certain specific conditions. However, it is unknown whether that effect is limited to weekends. ⋯ Total mortality was increased for admissions on Mondays, at night, and in all out-of-hours periods; late in-hospital mortality (after seven days) remained increased when the initial admission occurred on Mondays, at night or out of hours. It is likely that illness severity as well as resource and organisational factors are involved.
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Anaphylaxis is the quintessential medical emergency where prompt recognition and treatment is life-saving. In the UK the incidence is increasing year on year, and is most common in the sixth and seventh decades of life. More than half of cases are iatrogenic in nature, most of the rest are caused by venom (stings) and food substances. ⋯ Any delay in treatment is associated with increased risk of adverse outcome. Steroids and antihistamines are often given, although there is no convincing evidence of their effect in the acute setting. Where diagnostic uncertainty arises, serum tryptase levels can confirm or refute the diagnosis.