Emergency medicine journal : EMJ
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Many patients present late after a transient ischaemic attack (TIA). This delays intervention and may partly depend on where patients first present--emergency department (ED) or general practitioner (GP). Studying this behaviour could improve stroke prevention through better targeting of public education and allocation of resources. ⋯ Most patients presenting to an ED go urgently, whereas most going to a GP delay, particularly at weekends. Most Canadian patients, particularly those at high risk, go to an ED whereas most UK patients go to a GP. One way to reduce delay, particularly in the UK, would be to direct all patients with TIA to go to an ED rather than to their GP.
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Prehospital emergency care is provided in many European countries by specialised emergency physicians. However, little is known about the impact of experience and educational level of emergency physicians on providing prehospital care. ⋯ The effect of education on treatment process and outcome in prehospital emergency care should merit further research, especially to ensure that junior emergency physicians are properly trained before they work in prehospital emergency medicine.
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The case history is presented of a healthy 25-year-old man who was admitted to hospital after two syncopal episodes caused by carbon monoxide poisoning after smoking narghile. Clinicians should be aware of this association when they evaluate syncope in the emergency department, especially in narghile users.