Journal of accident & emergency medicine
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An audit of use of the telephone Helpline in the accident and emergency (A&E) department was conducted to establish the type of call, time, by whom the calls were made, appropriateness of advice given, and whether callers attended or not as advised, and also to obtain feedback from callers as to the degree of satisfaction with the advice given. ⋯ The Helpline has proved of benefit to the public. It is necessary and important to have protocols for common problems and to document all details carefully. It is also necessary that nursing staff are trained in handling the telephone queries and using the protocols. The use of a PC based system has improved data collection and also allows immediate access to protocols.
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To examine the use of accident and emergency (A&E) services by the homeless, with particular reference to the use of psychiatric services generated by this attendance. ⋯ There has been no significant increase in the use of A&E services by homeless people in the population studied over the eight year period. Several possible explanations for this are given.
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In this article we review the evidence supporting the clinical application of adrenaline in cardiopulmonary arrest, and summarize the receptor effects of catecholamines and the basic principles producing perfusion during CPR. Animal and human studies show that in cardiac arrest, adrenaline has positive haemodynamic effects, increasing systemic pressures, myocardial perfusion, and cerebrally directed flow. The problems extrapolating from animal to human data are highlighted. ⋯ There is no evidence that high doses of adrenaline improve survival to hospital discharge. Most studies comparing adrenaline with placebo have been non-randomised and uncontrolled, with major methodological problems. Conclusions are difficult, but if anything adrenaline is associated with poorer outcomes.
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To investigate how often elderly patients are discharged from an accident and emergency (A&E) department with unrecognized but remediable problems. ⋯ Elderly patients attending A&E merit special consideration to detect underlying medical or social problems.
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To estimate the proportion of prehospital deaths in a British population of trauma victims which may be preventable, and to investigate the effect of death at the scene and death in transit on potential survivorship. ⋯ There seems to be less scope for salvage of victims of trauma death in a British population than has been recorded in America, possibly due to a higher proportion of blunt trauma deaths here. Those who die in transit consist of a less severely injured group with a higher potential for survival.