Journal of accident & emergency medicine
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Two cases are described in which an inhalation anaesthetic was performed in order to secure an airway in patients with upper airway compromise. The agent used, sevoflurane, is relatively new and its properties are described. This is an important technique in which accident and emergency staff should obtain the appropriate supervised training.
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Comparative Study
Can the full range of paramedic skills improve survival from out of hospital cardiac arrests?
To examine the effect of full implementation of advanced skills by ambulance personnel on the outcome from out of hospital cardiac arrest. ⋯ No improvement in survival was demonstrated with more advanced prehospital care.
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Proposals for specialist registrar training in accident and emergency medicine in Mid-Trent Region are outlined. These may provide a framework for other schemes as well as stimulating further ideas.
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To test the hypothesis that limited paramedic advanced life support skills afford no advantage in survival from cardiac arrest when compared with non-paramedic ambulance crews equipped with defibrillators in an urban environment; and to investigate whether separate response units delayed on scene times. ⋯ The interventions of greatest benefit in out of hospital cardiac arrest are basic life support and defibrillation. Additional skills are of questionable benefit and may detract from those of greatest benefit.
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To investigate how well junior doctors in accident and emergency (A&E) were able to diagnose significant x ray abnormalities after trauma and to compare their results with those of more senior doctors. ⋯ The majority of junior doctors misdiagnosed significant trauma abnormalities on x ray. Senior doctors scored well, but were not infallible. This suggests that junior doctors are not safe to work on their own in A&E departments. There are implications for training, supervision, and staffing in A&E departments, as well as a need for fail-safe mechanisms to ensure adequate patient care and to improve risk management.