Emergency medicine journal : EMJ
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Severe neonatal hypothermia is an infrequent presentation to the Emergency Department. This case report describes the successful resuscitation and rapid rewarming of a newborn baby who presented to the Emergency Department with a core temperature of 14.8°C. This is the lowest temperature documented in the literature to date from which an infant has been successfully resuscitated.
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To develop and validate models to predict emergency department (ED) presentations and hospital admissions for time and day of the year. ⋯ Valid ED prediction tools can be generated from access to de-identified historic data, which may be used to assist elective surgery scheduling and bed management. The paper provides forecasting performance levels to guide similar studies.
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Consultant based delivery of emergency service is perceived to add value. This study aims to demonstrate the impact of such a service model based on consultant working in a UK emergency department. ⋯ A consultant based service delivery offers many advantages. These cannot be matched by either junior or middle grades. This would be in addition to the consultants' supervisory role. Consultant expansion is urgently required to achieve this sustainably. A further study evaluating the cost benefits of this service model is now underway.
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Recent initiatives in the Care of the Trauma patient in the UK have led to the establishment of Major Trauma Centres (MTCs), supporting a Trauma Network. It is envisaged that any person suffering from major trauma will be taken directly to one of these centres, with an expectant increase in survivability and decrease in morbidity. This will have an impact on the Ambulance Service in terms of journey times, and the MTCs in terms of bed days. Whilst these are not 'new' patients to the NHS, they may require a redistribution of funds. Most of the modelling into the effects of this has been carried out in London, which may not be applicable to more rural areas. We therefore determined to gain data on how a similar policy would affect trauma services in our rural region. ⋯ As this is more than 1 patient a day, there may be considerable strain on the MTCs and Ambulance Services. We believe service commissioners in rural areas need to consider the funding and organisational arrangements for major trauma in light of this.