Journal of accident & emergency medicine
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Case Reports
Malignant hypertension presenting as blurred vision in a 43 year old intravenous drug abuser.
A 43 year old intravenous drug abuser presented to the accident and emergency department with a three week history of bilateral visual loss and frontal headaches. Fundoscopy revealed bilateral retinal cotton wool spots and haemorrhages and an ophthalmic opinion was requested. ⋯ A diagnosis of malignant hypertension was made and blood pressure was gradually controlled on oral antihypertensives. This case illustrates the importance of checking the blood pressure of all patients presenting with visual loss.
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Budgetary responsibility gives you more control. Take time to master the fine detail, ask questions of your management and finance colleagues about anything you do not understand (you will not lose face), and develop the skills of lateral thinking and creative accountancy. Even if your budget is repeatedly overspent do not take it personally, ensure that management are aware of it and have a good night's sleep. Do not worry about it.
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The development of a workload management system for use in the accident and emergency department is described. The system is capable of capturing the work all professional groups, allowing the user to roster staff according to anticipated workload, and gives accurate information on whether staffing requirements are sufficient to provide the desired standard of care.
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To determine the value of advanced trauma life support (ATLS) training for medical staff in a major incident situation, based upon performance in a simulated exercise. ⋯ Medical staff who have either undertaken the full ATLS course or an abbreviated form of the course were more effective in their management of the simulated trauma cases.