European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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In-hospital primary surveys undertaken on traumatically injured patients can be inaccurate and incomplete. This study examined the documentation of prehospital primary surveys conducted by Greater Sydney Area Helicopter Emergency Medical Service registrars on trauma patients. ⋯ Helicopter emergency medical service registrars do not comprehensively document prehospital primary surveys on traumatically injured patients. However, emergency medicine trainees document more completely than anaesthetic trainees. Individual registrar variation contributes significantly towards the completeness of prehospital primary survey documentation.
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Pain is a common presenting complaint of emergency department patients. Providing instructions that can be easily recalled by patients is an important step in enabling patients to manage their pain following discharge. The effect of the introduction of written discharge instructions for pain medication on patients' recall of instructions was evaluated in this study. ⋯ In the second phase, significantly more patients, 71% (P<0.01), were able to recall the instructions correctly. Results of this study support the hypothesis that it makes sense to provide patients with written instructions about the appropriate use of analgesics, and that emergency departments that are not yet doing this should consider introducing this policy. It is a relatively low-cost measure that could lead to a significant improvement in quality of care.
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Tertiary trauma survey is widely implemented in trauma care to identify all injuries in trauma patients. However, various studies consistently show that some trauma patients have missed injuries. In this study, we developed a clinical decision model to identify patients who are at risk for delayed diagnosed injuries. ⋯ Our newly developed clinical decision model can identify patients who are at a risk for delayed diagnosed injuries and who should undergo an intensified search for potential unidentified injuries.
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There is increased demand for emergency healthcare by the public when abroad. This study aimed to investigate adults' reported level of knowledge about how to contact emergency healthcare services while abroad. A street survey was administered at various times, over several days, to 554 members of the general public who had been abroad in the previous 18 months. ⋯ Those fluent in the language of the country last visited were more likely to report knowing the emergency number for that country (54%), compared with those who were not (24.8%) (P<0.001). It is concerning that the majority of the general public do not appear to know how to contact emergency medical services while abroad. More targeted health education campaigns that address this are needed.
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There is growing emphasis on minimizing surgical delay for neck of femur fractures. Surgery within 36 h of diagnosis by the emergency department (ED) is classed as a key performance indicator. We aimed to determine the influence of the effect of time of presentation to the ED on surgical delay and 90-day mortality. The influence of age (<85 vs. ≥85 years) on these outcomes was also examined. ⋯ This study showed that the time of presentation to the ED could influence surgical delay. However, there was no direct relationship between surgical delay and 90-day mortality.