Emergency medicine journal : EMJ
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To determine the acceptability of an emergency medical dispatch (EMD) system to people who call 999 to request an ambulance. ⋯ Introducing EMD increases the amount of first aid and general advice given to callers, and satisfaction with these aspects of the service, while maintaining satisfaction with response times. Overall satisfaction with the service increased. However, some changes may be needed to prevent a small amount of dissatisfaction directly associated with EMD.
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To measure the level of patient satisfaction with an emergency department based chest pain assessment unit. ⋯ Chest pain assessment units are acceptable from a patient perspective.
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A short cut review was carried out to establish whether propofol is effective at stopping fitting in resistant status epilepticus. Altogether 24 papers were found using the reported search, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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To establish a chest pain observation unit, monitor its performance in terms of appropriate discharge after assessment, and estimate the cost per patient. ⋯ The chest pain observation unit is a practical alternative to routine care for acute chest pain in the United Kingdom. Negative assessment effectively rules out immediate, serious morbidity, but not longer term morbidity and mortality. Costs seem to be similar to routine care.
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In 1999, the Metropolitan Ambulance Service (MAS), Melbourne, Australia began implementing The Emergency Operations Plan (1998). One of the initiatives of the plan was the addition of crews with one advanced paramedic skills (APS) officer and one non-APS officer (mixed crews). All previous APS crews contained two APS officers working together. There was concern that mixed crews would have longer scene times than all-APS crews. This study aims to compare scene times at time critical cases for mixed crews and all-APS crews. ⋯ Mixed crews demonstrated shorter scene times than all-APS crews, although this is unlikely to be clinically significant. The concern that mixed crews would have longer scene time was not substantiated and should not be considered as a barrier to the development of mixed crew staffing models.