Emergency medicine journal : EMJ
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A very practical review of the evidence, indications and rationale for the perimortem cesarean section. Richard Parry describes the specific steps required to perform a PMCS, along with discussion of the pros and cons of different approaches. The importance of multidisciplinary training is emphasised.
summary -
Alcohol related hospital attendances are a potentially avoidable burden on emergency departments (EDs). Understanding the number and type of patients attending EDs with alcohol intoxication is important in estimating the workload and cost implications. We used best practice from previous studies to establish the prevalence of adult alcohol related ED attendances and estimate the costs of clinical management and subsequent health service use. ⋯ Alcohol related attendances are a major and avoidable burden on emergency care. However, targeted interventions at weekends and early morning hours could capture the majority of cases and help prevent future re-attendance.
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Prolonged emergency department (ED) stays make a disproportionate contribution to ED overcrowding, but the factors associated with longer stays have not been systematically reviewed. ⋯ Despite a sizeable body of literature, the available information is insufficiently precise to inform clinical or service-planning decisions; there is a need for a predictive model, including specific patient complaints. Deeper understanding of the determinants of ED LOS could help to identify patients and/or populations who require special intervention or resources to prevent a protracted stay.
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Multicenter Study
MARRIED-cocaine score: validating a tool for detecting the risk of ED revisit in cocaine users.
According to a previous study, 17% of patients who attended an emergency department (ED) following cocaine use returned to the same ED over the next year for a problem related to drug use. This previous study proposed a scale (Multicenter Assessment of the Revisit Risk In the Emergency Department (MARRIED)-cocaine score) to quantify the risk of ED revisit. The aim of the present study was to validate this scale by analysing a new set of patients attending for cocaine use in nine Spanish EDs. ⋯ The MARRIED-cocaine score has a moderate discriminative capacity to predict revisit among patients who attend the ED for cocaine drug-related emergencies, and allows classification of patients according to the risk of ED revisit.