Journal of the Royal College of Physicians of London
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J R Coll Physicians Lond · Jul 1992
Diagonal earlobe creases and atheromatous disease: a postmortem study.
The association between the grade of earlobe creases and degree of atheromatous disease was investigated in 376 postmortem examinations. Each earlobe crease was individually graded from 0 to 3. ⋯ The risk of death from myocardial infarction was 2.50 in men with high-grade creases and 3.70 in women. The earlobe crease is an important sign of atheromatous disease and it may be useful to include it in the clinical examination of patients.
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J R Coll Physicians Lond · Jul 1992
Practice Guideline GuidelineGuidelines for good practice in and audit of the management of upper gastrointestinal haemorrhage. Report of a joint working group of the British Society of Gastroenterology, the Research Unit of the Royal College of Physicians of London and the Audit Unit of the Royal College of Surgeons of England.
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J R Coll Physicians Lond · Jan 1992
Audit of an emergency ambulance service: impact of a paramedic system.
The purpose of this survey was to assess the workload of an emergency ambulance service, to describe the use of paramedic skills by those staff with full extended training, and to predict the impact upon the provision of pre-hospital care of deploying a paramedic on every emergency ambulance. Accordingly, a week-long survey was undertaken of all urgent and emergency calls received by an ambulance service covering a mixed urban and semi-rural area of 187 square miles with a population of 396,000. Of the total 682 emergency calls 351 (51.5%) originated from the '999' system: 291 of these patients were taken to hospital where 51% were thought to have minor conditions and 141 were admitted. ⋯ One patient was resuscitated from cardiac arrest. The presence of a paramedic on every emergency ambulance increases the time spent on-scene and offers advanced pre-hospital skills to patients who need them. Care should be taken to ensure that the benefits of time spent on-scene using such skills outweigh the disadvantage of delayed hospital admission.