BMJ open
-
The presentation of decrease blood pressure with tachycardia is usually an indicator of significant blood loss. In this study, we used the reverse shock index (RSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), to evaluate the haemodynamic status of trauma patients. As an SBP lower than the HR (RSI<1) may indicate haemodynamic instability, the objective of this study was to assess whether RSI<1 can help to identify high-risk patients with potential shock and poor outcome, even though these patients do not yet meet the criteria for multidisciplinary trauma team activation (TTA). ⋯ Among patients who did not reach the criteria for TTA, RSI<1 indicates a potentially worse outcome and a requirement for more attention and aggressive care in the emergency department.
-
This study sought to identify factors that may be associated with help-seeking by witnesses during overdoses where naloxone is administered. ⋯ Overdoses occurring on the street were associated with higher odds of seeking emergency medical help by responders. Further research is needed to determine if sex and stimulant use by the person who overdosed are associated with seeking emergency medical help. The results of this study will inform interventions within the British Columbia Take Home Naloxone programme and other jurisdictions to encourage seeking emergency medical help.
-
Multicenter Study Observational Study
Unit-based incident reporting and root cause analysis: variation at three hospital unit types.
To minimise adverse events in healthcare, various large-scale incident reporting and learning systems have been developed worldwide. Nevertheless, learning from patient safety incidents is going slowly. Local, unit-based reporting systems can help to get faster and more detailed insight into unit-specific safety issues. The aim of our study was to gain insight into types and causes of patient safety incidents in hospital units and to explore differences between unit types. ⋯ Comparable incidents and causes have been found in all units, but there were also differences between units and unit types. Unit-based incident reporting gives specific information and therefore makes improvements easier. We conclude that unit-based incident reporting has an added value besides hospital-wide or national reporting systems that already exist in various countries.
-
Studies have shown that dentists have a higher incidence of work-related musculoskeletal (MSK) pain than those in other occupations. The risk factors contributing to MSK pain among Saudi dentists has not been fully studied so this study aims to estimate the prevalence of MSK pain and investigate its associated risk factors among dentists in Saudi Arabia. ⋯ MSK pain is common among older and female Saudi dentists. Research on the impact of exercise and the ergonomics of the workplace on the intensity of MSK pain and the timing of its onset is required.
-
Little is known about levels of physical fitness in children from different ethnic groups in the UK. We therefore studied physical fitness in UK children (aged 9-10 years) of South Asian, black African-Caribbean and white European origin. ⋯ South Asian children have lower levels of physical fitness than white Europeans and black African-Caribbeans in the UK. This ethnic difference in physical fitness is at least partly explained by ethnic differences in physical activity.