International emergency nursing
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Although acts of threats and violence are problems that have received increased attention in recent years within Swedish pre-hospital care, only a handful of scientific studies have been carried out in this field. Threats and violence have a negative influence on the well-being of ambulance personnel. The aim in this study was both to investigate the incidents of threats and violence within the Swedish ambulance service and to describe these situations. ⋯ Commonly occurring physical violence was in the form of pushes, punches, kicks and bites. In most cases, the perpetrator was the patient himself often under the influence of alcohol or drugs. The most serious situations occurred when the reason for raising the ambulance alarm was intoxication or a decreased level of consciousness.
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The aim of the study was to describe the experiences of a group of triage nurses with patient-related workplace violence during the previous month. ⋯ In the context of the Emergency Department where patients present with a range of diagnoses and behaviours, it is unlikely that the issue of patient-related violence can be totally eliminated. However it can be prevented or managed more effectively on many occasions. Strategies to support staff and prevent and manage violence effectively should be a priority to provide a safe working environment and occupational health and safety for staff.
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To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals. ⋯ Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies.
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Management of battlefield casualties in Iraq and Afghanistan has seen considerable development in damage control resuscitation, which aims to address the risk of haemorrhage, initially due to mechanical damage; and thereafter due to the development of life-threatening coagulopathy. Damage control resuscitation combines a variety of techniques, such as the use of the combat application tourniquet and novel haemostatics, through to ground-breaking developments in transfusion protocols. ⋯ Meticulous trauma audit is included in this process and has allowed for rapid translation of knowledge into practice. The main elements of this doctrine are described.