Journal of accident & emergency medicine
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To review the activity of the nurse triage process. ⋯ The use of video in the triage room allows assessment of the triage process and is a valuable aid to training. Additionally, a potential visual audit tool has been identified.
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To determine present staffing levels, to find out problems, and to request solutions. ⋯ There are marked variations in recruiting ability across the country. Presently teaching hospitals are having no major difficulty, but others are only able to obtain junior doctors from outside the United Kingdom. Public expectations and charter standards are difficult to maintain. There is evidence of increasing stress among career and senior A&E medical staff. There is an inexorable but slow increase in year on year workload.
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Case Reports
Chest wall thickness may limit adequate drainage of tension pneumothorax by needle thoracocentesis.
Tension pneumothorax in a large man was inadequately drained by needle thoracocentesis with a 4.5 cm cannula. Unsuccessful needle thoracocentesis of a clinical tension pneumothorax in a large patient should be followed immediately by chest drain insertion, without local anaesthetic, as dictated by clinical urgency. If the clinical situation is still not improved other diagnoses should be considered.
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To explore the possibility that homeless people use the accident and emergency (A&E) department as a substitute for primary care and to quantify the role of alcohol abuse in their attendances. ⋯ The local homeless population may be using the A&E department as a substitute for primary care even in the presence of homeless healthcare facilities in the community. Heightened awareness of these facilities may improve their uptake. Alcohol plays a large role in homeless people seeking medical help in the A&E department. More accessible community facilities for dealing with this problem in this patient group are needed.
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To assess the number of attendances by hospital staff at an accident and emergency (A&E) department, and reasons for their attendance. ⋯ The increased use of A&E resources by staff other than doctors and nurses may be inappropriate and further research into their reasons for attendance is warranted.