Journal of accident & emergency medicine
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To assess the value of a cardiac technicians' report on electrocardiographs (ECGs) in reducing serious errors of interpretation by senior house officers. ⋯ When cardiac technicians provide a report on an ECG at the time of its recording, serious errors of interpretation by senior house officers are reduced.
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Over the last three years the accident and emergency trainees in Merseyside have developed a self directed training programme which now consists of twice monthly meetings. This has been achieved through a process of evolution, shaped by the core curriculum, and supervised by the region's consultants with the support of the postgraduate dean. The meetings have proved both popular and valuable. The development and format of the scheme is presented in the hope of stimulating others to work together to improve the training of specialist registrars.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intravenous chlorpromazine versus intramuscular sumatriptan for acute migraine.
To establish whether there is any difference in the efficacy of a chlorpromazine regimen and a sumatriptan regimen for the management of the pain of acute severe migraine. ⋯ The chlorpromazine and sumatriptan regimens studied are both very effective for the relief of the headache of severe migraine.
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Comparative Study
Axillary brachial plexus block--an underused technique in the accident and emergency department.
To compare axillary brachial plexus block and Bier's block as methods of providing upper limb anaesthesia. ⋯ Brachial plexus blocks are an alternative form of providing upper limb anaesthesia in the accident and emergency department. They are relatively simple to perform, well tolerated by patients, and have the advantage of providing prolonged analgesia without the need for additional medication.
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To determine the number of and reasons for rapid sequence inductions done by accident and emergency (A&E) doctors out of hospital as part of the activities of the MEDIC 1 Flying Squad. "Rapid sequence induction" was defined as any attempted endotracheal intubation accompanied by use of drugs to assist intubation and ventilation, including opiates, benzodiazepines, intravenous and topical anaesthetics, and neuromuscular blocking drugs. ⋯ The lack of complications related to rapid sequence induction in prehospital care suggests that this technique is safe when done by A&E doctors on appropriate patients.