Irish medical journal
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Irish medical journal · Jul 2008
The impact of legislation in Ireland on handheld mobile phone use by drivers.
Under the Road Traffic Act, 2006 handheld mobile phone use whilst driving is an offence liable to a fine and penalty points. The aim of this study was to determine whether there has been a change in driver behaviour following the introduction of this legislation. This study found that 2.3% of drivers were still using a handheld mobile phone.
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Audit of severe maternal morbidity is a potent tool in determining standards of maternity care. This study determines the incidence of severe acute maternal morbidity in our population, identifies the underlying organ dysfunction and associated obstetric risk factors, and compares them to published international reports. Over a 5 year period, 1999-2003, data were collected prospectively from patients with severe acute maternal morbidity. ⋯ This study identifies the feasibility of audit of severe maternal morbidity using simple defined clinical criteria. The incidence and underlying aetiology of severe maternal morbidity in our unit is comparable to other developed countries. It is essential that data on severe maternal morbidity are reviewed and analysed continuously at local hospital and national level to assess, maintain and improve clinical standards.
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Irish medical journal · May 2008
Neonatal resuscitation program guidelines 2006: ready, steady, can't go!
New evidence-based guidelines have been launched with recommendations that may impact how resuscitations, particularly of LBW infants, are enacted. ⋯ NRP is now an obligatory feature in all NICU's in Ireland compared to the 1990s when resuscitation training was disorganized and inconsistent. Variations in resuscitation practices still exist among different units. Many units may not be able to apply 2006 NRP guidelines especially for VLBW infants unless there is a significant investment in air/oxygen blenders, pulse oximeters, CO2 detectors and resuscitators that control peak pressures and CPAP/PEEP.
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Irish medical journal · Apr 2008
Patients presenting to an Ophthalmic Emergency Department after 5pm.
We analysed the attendance after 5pm at the Ophthalmic Accident and Emergency department of Royal Victoria Eye and Ear Hospital, Dublin over a period of 34 days. 345 patients attended, 203 (73%) were considered non urgent by the duty ophthalmologist. 12 (3.4%) required immediate admission. 245 (71%) self referred without an accompanying letter. There is a disproportionate amount of non emergency presentations to the RVEEH ophthalmic emergency department that leads to long waiting times and inefficient use of resources. By implementing a multifaceted educational and publicity programme and by improving access to daytime ophthalmic services we will eliminate the need for patients to attend our A&E with non-acute complaints after 5 pm. A new Accident and Emergency department policy is required to prevent inappropriate use of the service after 5 pm.
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Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. ⋯ Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.