Archives of emergency medicine
-
The object of this study was to assess the ability of junior doctors in the accident and emergency department to detect electrocardiographic (ECG) abnormalities. The ECG's performed in this department were monitored over a 4 week period. ⋯ Of those abnormalities which were graded as clinically significant only 2 (4.4%) were missed. The danger of missing acute changes is emphasized and proposals discussed which may reduce their frequency.
-
Randomized Controlled Trial Clinical Trial
Reducing the pain of intradermal lignocaine injection by pH buffering.
The effect of pH on the pain of administration and efficacy of 1% lignocaine was investigated in a prospective, double-blind, randomized study of 20 adult volunteers. Onset and spread of anaesthesia by intra-dermal injection were not altered, but there was a significant reduction in pain scores with a higher pH. Overall, pain scores appear to be more dependent on the speed of injection rather than alteration of pH.
-
Over a 1-month period all patients arriving in the accident and emergency department by ambulance following a '999' call were questioned using a standard proforma. They were assessed as to whether their medical condition warranted ambulance transfer. A number of social and practical points were analyzed to see whether they would identify any group of patients who used the emergency service without medical need. ⋯ Of these 178 (62%) were considered to have medically warranted an ambulance call whereas 111 (38%) did not. A number of features which were more likely to result in an unjustified call were identified. These would suggest that basic knowledge of first aid by the public is poor and should be improved.