Emergency medicine journal : EMJ
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Observational Study
Comparison of outcomes in patients with head trauma, taking preinjury antithrombotic agents.
This study compares clinical outcomes in patients with head trauma, taking preinjury antiplatelet drugs (aspirin, clopidogrel) and anticoagulants (warfarin). ⋯ A high proportion of patients taking warfarin underwent neuroimaging, but brain injury and admission rates were comparable between groups. There were no significant differences in short-term outcomes between the groups. The overall mortality is higher for patients on antiplatelet agents than warfarin.
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Street Doctors is an initiative set up by Liverpool medical students in 2008. The organisation aims to reduce the morbidity and mortality associated with violent crime by equipping 'at risk' young people with basic life support and first aid skills. The high prevalence of violent crime is indicated by NHS data from 2011/12, showing that 4,490 people were admitted to hospitals across England due to assault with a sharp object. With over 120 student volunteers, Street Doctors is now established in 6 cities where knife crime is becoming a persistent and worrying concern. ⋯ These results show the positive impact that street doctors are making. The vast majority of attendees leave feeling more confident in their ability to deal with a knife or gunshot wound in the critical moments before an ambulance arrives. As an ever expanding organisation, Street Doctors has an increasing potential to pass on the valuable skills that may one day be used to save a person's life.
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To describe the relationship between waiting time and patient satisfaction, and to determine predictors of overall care rating in an emergency department (ED) fast-track setting. ⋯ Waiting time was found to be highly predictive of patient satisfaction in an emergency fast-track unit with English language and NPs also associated with improved overall care rating. Future measures to improve patient satisfaction in fast-track units should focus on these factors.
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A shortcut review was carried out to establish whether night shift working worsens health and shortens life. 127 papers were found using the reported searches, of which one systematic review presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. It is concluded that shift work is associated with an increased risk of vascular events but does not appear to have an effect on mortality.
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The role of ambulance clinicians in providing psychosocial care in major incidents and emergencies is recognised in recent Department of Health guidance. The study described in this paper identified NHS professional first responders' needs for education about survivors' psychosocial responses, training in psychosocial skills, and continuing support. ⋯ Ambulance clinicians recognise their own education needs and the importance of their being offered psychosocial training and support. The authors recommend that, in order to meet patients' psychosocial needs effectively, ambulance clinicians are provided with education and training in a number of skills and their own psychosocial support should be enhanced.