Emergency medicine journal : EMJ
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The London Trauma Network was launched in April 2010 in order to centralise trauma care in the capital city. The consultation and resourcing of the four new major trauma centres (MTC) was adult focused. The objective of this study was to assess the impact that adult MTC status has on paediatric trauma workload. ⋯ Major adult trauma centre status has a significant effect on paediatric trauma workload and hence resources. When reconfiguration of trauma services are being considered it is essential to take into account the impact on paediatric services alongside those of the adult population.
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Redbridge Tackling Knife Crime Programme was an initiative run between Redbridge Safer Communities Partnership, a London-based police force and Barking, Havering and Redbridge University Hospital Trust. It comprised of data collection resulting in the analysis of types of assault, locations, demographics of both assailant and victim and were police informed. Domestic violence (DV) was identified as a category of assault. The inspiration came from the 1996 'Cardiff-model'-the Violence Prevention Group shared ED assault data with its police force. The outcome led to enhanced effectiveness of the police in managing alcohol-related violence. The TKAP aim is it identify DV locations and patterns, otherwise unknown to police by improved intelligence gathered through ED data. As a result police deployment can reflect areas of need and allow police to compare their own figures allowing a more informed service for DV victims. ⋯ will be used to implement police enforcement activities and prevention work, hence improving safe-guarding.
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Paracetamol poisoning is common worldwide. Standard intravenous N-acetylcysteine (NAC) therapy is complex, and commonly associated with concentration-related adverse effects and the potential for administration errors. We aimed to determine whether adverse effect incidence could be reduced by antiemetic pre-treatment and/or a simpler and shorter intravenous N-acetylcysteine regimen. ⋯ In patients with paracetamol poisoning requiring acetylcysteine, adverse effects were substantially reduced by ondansetron pre-treatment and by using a modified, shorter treatment regimen. Ondansetron, but not the modified regimen, increased the frequency of liver function abnormalities. If large effectiveness studies confirm the modified regimen is non-inferior to conventional then shorter and safer treatment would be possible for this common poisoning.
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Many emergency medicine clinical trials have struggled to recruit to 'time and target' with investigators having to make a large additional effort or extend the time for recruitment. This study was performed to describe our experience in the use of a computer 'app' to facilitate the process of research subject identification and communication between the ED staff and the research team. Key questions were: 1) Does the introduction of an iPad 'app' result in a greater rate of patient notification to the research team? 2) Which type of notification method was most used? ⋯ There was a significant increase in the immediacy of communication after the introduction of the iPad app. This occurred without a large amount of input from the research team, and seemed to be due to the staff knowing a specific location for the system and the ease of use, with the whole process taking less than 20 seconds. ED staff seemed to prefer using the 'app', as after it was introduced there was very little use of the well publicised 'research hotline' phone number. Information and communications technology can aid in the timely identification of potential research subjects in emergency care.