Emergency medicine journal : EMJ
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To estimate the prevalence of post-concussive symptoms (PCS) following head injury among adolescents in full-time education and to identify prognostic factors at presentation to the emergency department (ED) that may predict the development of PCS. ⋯ The prevalence of PCS 6 months following head injury for the selected sub-group was 5.9%, and 10.6% if assaulted. Most patients who developed PCS were discharged directly from the ED.
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Rapid access to emergency medical services (EMS) is essential at the onset of acute stroke, but significant delays in contacting EMS often occur. ⋯ Many callers seek lay or professional advice prior to contacting EMS and some believe that the onset of acute stroke symptoms does not warrant an immediate 999 call. More public education is needed to improve awareness of stroke and the need for an urgent response.
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To estimate the potential of alternative providers of care for minor health problems to reduce demands on emergency departments (EDs). ⋯ Although there appears to be considerable potential for minor conditions to be managed in settings other than the ED, our findings indicate that patients will continue to present these conditions to the ED. Patient perceptions of the urgency of their treatment need, and also the availability and capacity of alternative services may be offsetting their potential to substitute for the ED. Advice from other services may be contributing to demands on the ED.
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After acute intoxication, most patients presenting to the emergency department (ED)--76% of them in The Netherlands--are admitted to hospital. Many will not need medical treatment on the ward. The authors tested two algorithms in the ED, based on vital parameters, ECG findings, and ingested substances, to identify patients who will receive treatment in hospital. ⋯ The algorithms had good sensitivity and better specificity than current clinical practice in most hospitals. It is too early to advocate their implementation, but results indicate that it is possible to use clinical parameters objectively to reduce unnecessary admissions to the ward.