European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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To evaluate the reasons behind the demographic characteristics of patients presented to emergency departments. ⋯ Demographical trends show that emergency department visits by elderly patients would increase in time. So, in Turkey, emergency department staff should be trained to provide for the special needs of this population in emergency departments.
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The objectives were to demonstrate the extra workload for emergency medicine of inpatient management of mild/moderate head injuries and to determine the effectiveness of current computed tomography guidelines. ⋯ Implementation of the Galasko report has resource, manpower and training implications for emergency medicine. The current computed tomography guidelines should be modified to include Glasgow coma score<15 and neurological symptoms for example, vomiting and alcohol-related falls.
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A prospective study was conducted to examine clinical practices in the management of head-injured patients preinception and postinception of the Scottish Intercollegiate Guidelines Network guidelines. Comparison was made between the Scottish Intercollegiate Guidelines Network and National Institute for Clinical Excellence guidelines on their indications for computed tomography scanning. Information was available on 2827 adult patients. ⋯ Four hundred and seventy-eight patients fulfilled one or more National Institute for Clinical Excellence criteria for scanning. No patient with Scottish Intercollegiate Guidelines Network or National Institute for Clinical Excellence indications for computed tomography scanning and who was not scanned, subsequently required neurosurgical treatment for a complication related to their injury. Full compliance with the scanning recommendations in the Scottish Intercollegiate Guidelines Network and National Institute for Clinical Excellence guidelines will require a significant increase in scanning resource and is unlikely to lead to the identification of a significant additional number of patients with intracranial lesions requiring neurosurgical intervention.
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Multicenter Study
Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients.
The impact of prehospital care after the return of spontaneous circulation in out-of-hospital cardiac arrest patients is not known. This study describes adherence to the resuscitation guidelines, factors associated with poor adherence and possible impact of prehospital postresuscitation care on the outcome of out-of-hospital cardiac arrest. ⋯ Less than 50% of out-of-hospital cardiac arrest patients received prehospital postresuscitation care compatible with the current guidelines. Markers of poor prognosis were associated with unsatisfactory care, which in turn was more frequent among the patients who did not survive to hospital discharge. The importance of the guidelines should be highlighted in the future.
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To determine changes in volume and timing of accident and emergency (A&E) attendances associated with the Rugby World Cup Final 2003. ⋯ In the West Midlands, it appears that attendance was reduced in the hours immediately surrounding the final, but in subsequent hours attendances increased, potentially as a result of celebration of the win. In New South Wales, the final was associated with reduced attendance in the hours leading up to the final, but they quickly returned to normal. Major sporting events can influence accident and emergency workload.