Emergency medicine journal : EMJ
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Although prehospital treatment algorithms have changed over the past years, the prehospital time of multiple trauma patients of some 70 min and the on-scene-treatment time (OST) of some 30 min have not changed since 1993. The aim of this study was to critically assess specific interventions and conditions at the scene in relation to their impact on prehospital rescue intervals. ⋯ This study identified characteristic interventions and conditions with significant impact on prehospital treatment times. Current treatment concepts should be re-evaluated with respect to these results.
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Rapid access to acute stroke care is essential to improve stroke patient outcomes. Policy recommendations for the emergency management of stroke have resulted in significant changes to stroke services, including the introduction of hyper-acute care. ⋯ The stroke awareness social marketing campaign has contributed to public knowledge and was perceived to assist in reducing prehospital delay. It has also resulted in an enhanced knowledge of the significance of rapid treatment on admission to hospital and raised public expectation of EMS and stroke services to act fast. More research is required to assist organisational change to reduce in-hospital delay.
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To determine if complications from blunt thoracic trauma are reduced with patient-controlled analgesia (PCA) compared with interval analgesic dosing given as needed. Secondary aims were to investigate the influence of PCA on hospital length of stay (LOS) and cost. ⋯ PCA did not reduce complications, hospital LOS or costs compared with interval analgesic dosing.
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Emergency department (ED) crowding causes prolonged waiting times. ⋯ In a busy and crowded ED, the introduction of clinical assistants to an existing emergency health service effectively reduces patient waiting times and decreases the number of patients leaving without being seen.
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This paper outlines the emerging best practice when packaging a prehospital trauma patient while providing spinal immobilisation. The best practice described is based on the recommendations of a consensus meeting held by the Faculty of Pre-Hospital Care, Royal College of Surgeons of Edinburgh, in the West Midlands in April 2012, where the opinion of experienced practitioners from across the prehospital and emergency care community considered the currently available evidence and reviewed current clinical practice. ⋯ The recommendations drawn from the meeting and subsequent dialogue represent a 'general agreement' to the principles and practices described in the paper. The recommendations will provide guidance for clinical practice and governance alongside other consensus statements from the Faculty of Pre-Hospital Care that seek to address prehospital spinal immobilisation and pelvic immobilisation.