Archives of emergency medicine
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The recent changes in NHS management structure have allowed us for the first time, to estimate the cost of treatment of an illness. We wanted to determine the treatment cost of a case of deliberate self-harm (DSH) to a large University Teaching Hospital and to this aim, we reviewed the case notes of 190 consecutive cases of deliberate self-harm presenting to A&E. On average, each attendance costs 425.24 pounds, from attendance to A&E to hospital discharge.
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Randomized Controlled Trial Clinical Trial
The MiniCAP III CO2 Detector: assessment of a device to distinguish oesophageal from tracheal intubation.
A new portable infra-red CO2 detector was assessed in 50 intubated patients. This device was 100% accurate in distinguishing between tracheal and oesophageal intubation when used by nursing and paramedic personnel.
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The use of a helicopter as a primary response vehicle for the Cornwall Ambulance Service is presented. A brief analysis of the activities of the First Air Ambulance is described and an appraisal of its effects on the overall performance of the Service is given. Emphasis is given to patient acceptability and also to the flexibility of the helicopter in terms of its response to different situations. In conclusion, The Air Ambulance, as part of an integrated ambulance service, is an effective provider of good pre-hospital care.
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Letter Case Reports
Massive haemothorax from central venous catheterization: a note of caution.
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An irregular discharge (ID) from the A&E department is an undesirable, but relatively common occurrence. A prospective study was undertaken to quantify the size of the problem and by arranging a subsequent review of the patient, to determine the clinical outcome. Over a 3-month period, 139 patients (0.73%) of attendances) took their own discharge against medical advice. ⋯ Patients with serious conditions appeared to return spontaneously for further care. Methods of minimizing the numbers of patients who take an ID or DNW are discussed. Taken together, the numbers of these attenders leaving prematurely, can be used as a valid performance indicator of the delivery of health care in the A/E department.