Emergency medicine Australasia : EMA
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Emerg Med Australas · Aug 2007
Randomized Controlled Trial Comparative StudyComparison of lignocaine and water-based lubricating gels for female urethral catheterization: a randomized controlled trial.
It is standard practice to use lignocaine gel during male urethral catheterization. However, it is commonly believed that topical anaesthetic confers no benefit during female catheterization hence lubricating gel alone is more commonly used. The present study aimed to determine whether lignocaine gel decreased pain compared with water-based lubricating gel for female urethral catheterization in the ED. ⋯ Lignocaine gel substantially reduces the procedural pain of female urethral catheterization by comparison with use of a water-based lubricating gel.
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The largest democracy on earth, the second most populous country and one of the most progressive countries in the globe, India, has advanced tremendously in most conventional fields of Medicine. However, emergency medicine (EM) is a nascent specialty and is yet to receive an identity. Today, it is mostly practised by inadequately trained clinicians in poorly equipped emergency departments (EDs), with no networking. ⋯ The present article intends to highlight factors that continue to challenge the handful of dedicated, full time emergency physicians who have tenaciously pursued the cause for the past decade. A three-pronged synchronous development strategy is recommended: (i) recognise the specialty of EM as a distinct and independent basic specialty; (ii) initiate postgraduate training in EM, thus enabling EDs in all hospitals to be staffed by trained Emergency physicians; and (iii) ensure that EMs are staffed by trained ambulance officers. The time is ripe for a paradigm shift, since the country is aware that emergency care is the felt need of the hour and it is the right of the citizen.
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Emergency medicine in the highly advanced world is traditionally performed in two different ways. The first is the well-known Anglo-American system with skilled EDs, and a pre-hospital emergency medical service utilizing paramedics. The second is the so-called Franco-German system, with a highly developed pre-hospital emergency physician service, but only a basic organization of hospital-based emergency medicine. ⋯ The last milestone, the development of academic emergency centres, has only just started. This process will take some time. The present paper describes the present and future of emergency medicine in some European countries using these criteria.
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Emerg Med Australas · Aug 2007
Factors affecting severity of bicycle-related injuries: the role of helmets in preventing head injuries.
To identify factors that affect the severity of bicycle-related injuries in patients with head injury compared with those without, so as to find whether the effect of using helmets extends beyond head protection, and to explore a direct protective effect of helmets on head injuries. ⋯ The reduced severity of injury in helmeted patients is because of protection of the head and not other body regions.
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Emerg Med Australas · Aug 2007
Multicenter StudyWhy patients attend emergency departments for conditions potentially appropriate for primary care: reasons given by patients and clinicians differ.
To compare reasons identified by clinical staff for potential primary care attendances to the ED with those previously identified by patients. ⋯ These data confirm that clinician perspectives on reasons for potential primary care patients' use of ED differ quite markedly from the perspectives of patients themselves. Those differences do not necessarily represent a punitive or blaming philosophy but will stem from the very different paradigms from which the two protagonists approach the interactions, reflecting the standard tension in a provider - consumer relationship. If policy is to be developed to improve system use and access, it must take both perspectives into account with respect to redesign, expectations and education.