Emergency medicine journal : EMJ
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Adverse drug reactions (ADR) cause considerable morbidity and mortality. ⋯ This study estimated the incidence of ADR-related admissions to an Irish hospital at 8.8%, with 57.3% of these deemed to have been potentially avoidable. Older patients were more likely to have an ADR-related admission. Prescribers must be aware of this increased likelihood of an ADR when prescribing new drugs to this patient population, and regularly review treatment.
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A short-cut review was carried out to establish whether the pulmonary embolism rule-out criteria (PERC) can safely exclude the diagnosis of pulmonary embolism (PE) in the emergency department (ED). One recent systematic review was directly relevant to the question and incorporated all the other relevant evidence identified. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 3. The clinical bottom line is that PERC may be safely applied to patients aged 18-49 years presenting to the ED with chest pain and/or dyspnoea providing that the pre-test probability of PE is 7% or less (equivalent to a Wells score of <2).
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Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.
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Ambulance workers are regularly exposed to call-outs, which are potentially psychologically traumatic. The ability to remain objective and make adaptive appraisals during call-outs may be beneficial to this at-risk population. This pilot study investigated the links between cognitive appraisals, objectivity and coping in ambulance workers. ⋯ Ambulance workers may benefit from psychological interventions, which focus on cognitive reappraisal and enhancing objectivity to improve coping and resilience.
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Comparative Study
Emergency medical admissions, deaths at weekends and the public holiday effect. Cohort study.
To assess whether mortality of patients admitted on weekends and public holidays was higher in a district general hospital whose consultants are present more than 6 h per day on the acute medical unit with no other fixed clinical commitments. ⋯ Patients admitted as emergencies to medicine on public holidays had significantly higher mortality at 7 and 30 days compared with patients admitted on other days of the week.