Journal of accident & emergency medicine
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Severe hypothermia is a medical emergency and requires active and occasionally rapid core rewarming to prevent cardiac arrhythmias and death. In the accident and emergency department rewarming is often limited to warmed intravenous fluids, heated blankets, gastric and bladder lavage. ⋯ Venovenous haemofiltration is now commonly found in district general hospitals around the country and can be used safely for core rewarming. A case is reported of a severely hypothermic elderly patient successfully rewarmed using venovenous haemofiltration, in an accident and emergency department, when other conventional methods had failed.
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Patients over the age of 75 years comprise an increasing proportion of accident and emergency (A&E) department attendances. Within this group there is a high incidence of comorbidity, which mandates effective discharge coordination from the A&E department. ⋯ Telephone follow up of patients over 75 attending our A&E department identified a number of areas where care could be improved before and after discharge. This low cost, high quality intervention has the potential for decreasing inappropriate return visits to the department by a vulnerable group of patients as well as improving overall quality of care.