Emergency medicine journal : EMJ
-
Circulating leucine-rich α-2-glycoprotein-1 (LRG1) protein has been found in the plasma and urine of patients with acute appendicitis (AA) and may be useful for diagnosis. The present study aimed to investigate whether circulating LRGI mRNA levels also improve the early diagnosis of AA. ⋯ This research study was supported by a Direct Grant for Research from the Chinese University of Hong Kong (reference no.: 2041642) (HK$18000).
-
To determine whether the Emergency Department (ED) could effectively identify patients with suspected cauda equina or cord compression who warranted further investigation with MRI, and thus request MRI without prior review from neurosurgeons. ⋯ There was good correlation between ED and NS opinion on the need for MRI. Detection rate for cauda equina/severe stenosis (20.6%) was in keeping with other studies in the literature. There is significant time delay in the current referral process which can delay emergency treatment and may adversely affect patient outcome, and one patient was missed despite the proforma recommending MRI. ED doctors should request MRIs directly in the case of suspected cauda equina/cord compression . emermed;31/9/782-a/EMERMED2014204221F8F1EMERMED2014204221F8 Patient outcomes at each stage. emermed;31/9/782-a/EMERMED2014204221F9F2EMERMED2014204221F9 Outcome of MRI including detection rate of cauda equina or severe spinal stenosis. emermed;31/9/782-a/EMERMED2014204221F10F3EMERMED2014204221F10 Times between being seen by ED doctor, NS referral and MRI in all patients and patients subsequently requiring an emergency operation.
-
The planning of regional emergency medical services is aided by accurate prediction of urgent ambulance journey times, but it is unclear whether it is appropriate to use Geographical Information System (GIS) products designed for general traffic. We examined the accuracy of a commercially available generic GIS package when predicting emergency ambulance journey times under different population and temporal conditions. ⋯ It is reasonable to estimate emergency ambulance journey times using generic GIS software, but in order to avoid insufficient regional ambulance provision it would be necessary to make small adjustments because of the tendency towards systematic underprediction.
-
To survey the attendance of patients presenting with a head injury (HI) at a UK emergency department (ED), identifying numbers, types of service and referral routes; to survey subsequent service use and to highlight the challenges in service planning and identifying which patients may potentially benefit from follow-up/rehabilitation input. ⋯ These study findings highlight the difficulties in identifying patients who would benefit from follow-up, in particular after mild HI. Our study findings will form the basis of a long-term follow-up study.
-
EM and Paediatrics are specialties at the forefront of the move towards 24/7 consultant delivered care. This shift has been partly driven in EM by trauma pathways, as well as aiming to provide better patient care, and to support training.Chelsea and Westminster Paediatric ED sees around 34,000 children a year. It is not a major trauma centre. In May 2013, 6 consultant paediatricians were appointed to be resident in PED at night. This study evaluates the PED team's perceptions of the impact of this change on the quality of clinical care, training and job satisfaction, and of trainee's views of undertaking a similar role in the future. ⋯ PED staff at C&W have welcomed the move to 24/7 consultant delivered care. The core aims - to improve the efficiency and proficiency of patient care, and to better utilise out of hours working as a training opportunity - are being achieved. Concerns remain about disempowerment of senior trainees and the perceived impact of night shifts in a consultant role on work-life balance. To sustain this model, trainees must be convinced of the benefits of becoming a resident consultant upon their own career.