Journal of accident & emergency medicine
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To examine the use made of 24 hour access to computed tomography from an accident and emergency (A&E) department and to assess whether clear benefits for patients could be identified by having such a service. ⋯ Computed tomography facilities allow comprehensive initial evaluation of the head injured patient and minimise hazardous and expensive transfer of these seriously ill patients. Experience shows that it is a vital tool in the initial differential diagnosis of the comatose patient and therefore must be available for use by senior and middle grade A&E staff on a 24 hour basis.
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To determine the ability of nurse practitioners to use the Ottawa ankle rules by comparing their requests for radiography with those of senior house officers (SHOs). ⋯ Nurse practitioners trained to use the Ottawa ankle rules are as effective as SHOs in the implementation of the rules. Moreover the sensitivity and specificity of the Ottawa ankle rules was similar to that seen in other studies.
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Comparative Study
Emergency intubation of infants: does laryngoscope blade design make any difference?
To compare intubation times and ease of use for a range of infant laryngoscope blades in the hands of accident and emergency (A&E) personnel. ⋯ No current standard exists regarding the utilisation of infant laryngoscope blades in the A&E department. The first line blade available should be a C shaped blade (Miller, Oxford, Robert-shaw, or Wisconsin). Other blade designs should be kept for use only by more experienced personnel or in difficult intubation situations. Intubation training must focus on correct technique and regular assessment is essential.