Emergency medicine journal : EMJ
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Emergency departments are one of the highest risk areas in health care. Emergency physicians have to assemble and manage unrehearsed multidisciplinary teams with little notice and manage critically ill patients. With greater emphasis on management and leadership skills, there is an increasing awareness of the importance of human factors in making changes to improve patient safety. ⋯ Therefore, there remains an educational gap that we need to fill before an emergency physician is equipped to function as a team leader and manager. This review will examine the lessons from aviation and how these are applicable to emergency medicine. Solutions to averting errors are discussed and the need for formal human factors training in emergency medicine.
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A short-cut review was carried out to establish whether ambulatory patients immobilized in a below knee plaster of paris cast and administered with a prophylactic dose anticoagulation with low molecular weight heparin; LMWH can benefit from a reduced risk of venous thromboembolism within the next 90 days One Cochrane Review was relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the use of LMWH thromboprophylaxis is effective at reducing the incidence of VTE in these patients.
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A short-cut review was carried out to establish whether abdominal pain on hopping/jumping can assist in the initial diagnosis of appendicitis in children. Four studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the presence of abdominal pain when asked to hop seems to be both reasonably sensitive and specific to a diagnosis of appendicitis in children.
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A short-cut review was carried out to establish the sensitivity and specificity of CRP as a tool for diagnosing bacteraemia. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line suggests that CRP is not a useful tool in the initial diagnosis of severe bacterial infection.
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Emergency management is a relatively new research field in China. The severe acute respiratory syndrome epidemic in 2003 caused research and papers on emergency management to increase by leaps and bounds. This review summarises the progress of hospital emergency management research in China, highlights trends and challenges, and discusses likely solutions for research improvement. ⋯ Based on this study we suggest that hospital emergency management research in China should make efforts to (1) establish a universally accepted theory framework and terminology, (2) create a structure for further studies, (3) integrate research of different disciplines, and (4) avoid or minimise confusion. More attention should be paid on the evolvement mechanism of main public health incidents and disasters, and the key functional systems related to hospital's emergency response resiliencies. Focus should also be placed on practical guidelines and tools.