Emergency medicine journal : EMJ
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Comparative Study
Frequent users of US emergency departments: characteristics and opportunities for intervention.
To compare the characteristics of US adults by frequency of emergency department (ED) utilisation, specifically the prevalence of chronic diseases and outpatient primary care and mental health utilisation. ⋯ Frequent ED users had a large burden of chronic diseases that also required high outpatient resources. Interventions designed to divert frequent ED users should focus on chronic disease management and access to outpatient services, particularly for Medicaid beneficiaries and other high risk subpopulations.
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Mass media campaigns for stroke awareness encourage the public to recognise stroke symptoms and respond to stroke in a timely manner. However, there is little evidence to suggest that media messages can influence behaviour after stroke onset. The F.A.S.T. (Face Arm Speech Time) test is a common stroke recognition tool used in public education campaigns. ⋯ This first Irish F.A.S.T. campaign had an initial impact on ED attendance of patients with stroke symptoms. However, the campaign effects were not sustained in the long term. Results indicate that prehospital delay in accessing acute stroke services is a complex process with involvement of factors other than stroke knowledge and intention to call 911.
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To examine the predictors and temporal patterns of head injury (HI) presentation in the emergency department among cohorts of homeless and low-income housed men. ⋯ Having an HI is better predicted by previous head injuries, drug dependence or a seizure disorder than a history of homelessness or alcohol dependence. HIs may become more frequent with time.
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Transport of critically ill children has become necessary following centralisation of paediatric specialist services. Children's Acute Transport Service (CATS) retrieves critically ill children in the Greater London area. Our teams have had to stop during these journeys to assist in road traffic accidents or ill passers-by. ⋯ Our teams had to stop on 12 occasions over this period amounting to an incidence rate of 1 per 959 ambulance journeys. Although this is an infrequent occurrence, the impact on the retrieved patient and service delivery could be significant. We would like to direct the attention of transport services to this problem.