Journal of accident & emergency medicine
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A specialist transfer team based in the regional intensive therapy unit (ITU) at the Western Infirmary, Glasgow, acts as a central interhospital retrieval team for Glasgow and the west of Scotland. The establishment of trauma systems has been proposed. This paper describes the activities of the specialist transfer team to illustrate the potential role of a central retrieval team within such a system.
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Victims of near hanging are being increasingly seen in accident and emergency (A&E) department. This paper reports on seven cases of near hanging seen over four years in a district general hospital. The mechanism of injury is ligature strangulation rather than cervical spinal cord injury. All cases of near hanging should be actively and vigorously resuscitated, as initial presenting features bear a poor correlation to eventual outcome.
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The organisation of on-site medical personnel and facilities is described for an open air rock concert attended by 62,000 people. Care of the majority of patients was completed on site, avoiding an increased workload for local hospitals and general practitioners. Many of the head injuries could have been avoided by preventing the distribution of promotional items and large drinks containers which were thrown as missiles.
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To analyse the diagnoses made in children presenting to an accident and emergency (A&E) department with seizures. ⋯ The children studied had a very different spectrum of problems from adults. A&E staff should be aware of the range of problems in children who present with seizures. Experienced paediatric staff should be available to assist all A&E departments where children are seen.
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Work was carried out to determine whether patients requiring emergency medical or surgical admission to hospital via accident and emergency (A&E) departments benefit from initial assessment by the ward senior house officer (SHO) as well as the A&E SHO. Two comparable consultant-led A&E departments sharing the same catchment population and receiving similar numbers of new patients each year were studied. A panel of four consultants audited the A&E notes and in-patient records of consecutive emergency medical and surgical patients admitted to two hospitals over the same 6 month period. ⋯ Diagnostic errors, inappropriate admissions to hospital and admission of patients to inappropriate wards were used as outcome measures. There was no significant difference in the rates of diagnostic error or inappropriate admissions between those patients seen by an A&E SHO only, and those seen in A&E by the A&E and ward SHOs. Detaining emergency medical and surgical patients in the A&E department for further assessment by ward SHOs does not alter inappropriate admission rate or improve diagnostic accuracy.