Emergency medicine journal : EMJ
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Multicenter Study Comparative Study
Emergency department staffing in England and Wales, April 2007.
To determine medical and nursing staffing levels in emergency departments in England and Wales. ⋯ There is great variability in staffing numbers in similar-sized departments, and most departments are understaffed in comparison with the recommendations of the British Association for Emergency Medicine to achieve the 4 h target at the 90% level.
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Preclinical actions in the primary assessment of victims of blunt trauma may prolong the time to definitive clinical care. The aim of this study was to examine the duration of performed interventions and to study the effect of on-scene time (OST) and interventions performed before admission to hospital on hospital resuscitation time. ⋯ For most trauma patients the initial life- and limb-saving care is achieved within the "golden hour". Prehospital treatment occupies most of the golden hour. More prehospital interventions were performed with HEMS than with EMS only, but the higher number of interventions did not result in a longer OST with HEMS. Although the numbers of subsequent in-hospital interventions may be lower, no reduction in time in hospital may be expected from the interventions performed before hospital admission.
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Although widely acknowledged, few data exist on the scope of general practice involvement in the management of prehospital emergencies. A study was undertaken to explore the frequency and types of emergencies dealt with and the interventions undertaken by GPs who had completed Immediate Care training. ⋯ GPs make frequent use of a wide range of interventions in prehospital emergencies. Issues relating to tailored training, adequate equipment, collaboration with the emergency services and skills maintenance are highlighted by these data.