Journal of accident & emergency medicine
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To ascertain the prevalence and experiences of triage nurse requested x ray systems among accident and emergency (A&E) departments in the UK. ⋯ The system of triage nurse requested x rays is generally well received and departments considering adopting this system can be reassured. Pitfalls and possible protocols for A&E departments intending to start triage nurse requested x rays are suggested.
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Randomized Controlled Trial Clinical Trial
Triage nurse requested x rays--are they worthwhile?
To study an established triage nurse x ray requesting system to determine whether sending defined groups of patients for radiography before assessment by doctors or emergency nurse practitioners (ENPs) resulted in shorter waiting times for patients without compromising quality of care. ⋯ A triage nurse x ray requesting system speeds up the progress of walking wounded patients through the department without compromising service quality. Further benefits are staff and patient satisfaction and a greater sense of team working for all staff.
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Fat embolism syndrome remains a rare, but potentially life threatening complication of long bone fractures. The true incidence is difficult to assess as many cases remain undiagnosed. ⋯ Two cases of post-traumatic cerebral fat embolism, manifested by prolonged coma and diffuse cerebral oedema, are presented. The clinical course of the disease as well as the intensive care unit management are discussed.
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Effective communication between the physician and patient is required for optimum post-emergency department management. Written emergency department discharge instructions, when used to complement verbal instructions, have been shown to improve communication and patient management. ⋯ The desirable features of discharge instructions are described. It is recommended that structured, pre-formatted instruction sheets be provided to all patients discharged to home, that emergency departments establish uniform policies to promote best practice in communication, and that the use of discharge instructions be considered as an emergency department performance indicator.