Emergency medicine journal : EMJ
-
Trauma remains a significant cause of mortality and morbidity. Non-compressible torso haemorrhage is one of the key drives of these mortality data. Our contemporary management has focused on damage control resuscitation, with a focus on haemorrhage control, haemostatic resuscitation and permissive hypotension. ⋯ In this paper, we suggest that perhaps more consideration should be given to the diastolic blood pressure in bleeding trauma patients. The diastolic blood pressure is critical for coronary perfusion, and in turn the cardiac output responsible for cerebral blood flow. We suggest that a move to reframing resuscitation in terms of physiology may change the way that we resuscitate these patients and allow for more nuanced treatment strategies.
-
Pulse oximetry measures oxygen saturation non-invasively by using differential absorption of infrared signals which are dependent on the oxyhaemoglobin:deoxyhaemoglobin ratio. We tested the hypothesis that pulse oximetry error in measurements of blood oxygen saturations may be associated with blood haemoglobin levels. ⋯ As blood haemoglobin decreases, the oxygen saturation measurement derived from a pulse oximeter reads erroneously higher than the true value measured by ABG. While this study was confined to patients with COVID-19, physicians should be aware of this potential discrepancy among all patients with haemorrhage or known anaemia.
-
Growing numbers of avoidable low-acuity visits to emergency departments (ED) are a major health policy concern globally and are thought to contribute to ED crowding. This study explores the differences in the utilisation of low-acuity ED visits between culturally and linguistically diverse (CaLD) migrants and English-speaking background (ESB) population. ⋯ Foreign-born migrants aged 45 and over from CaLD backgrounds tend to have the lowest rates of low-acuity ED visits, particularly those who migrated more recently indicating low-acuity visits by CaLD patients are unlikely to contribute to ED crowding.
-
Stress and burnout are prevalent among emergency department (ED) staff in the UK. The concept of well-being interventions for ED staff is a growing area of interest and research worldwide. Various interventions are described in the literature, yet little is known about the experience of ED staff in the UK of interventions designed to support their well-being. This study therefore aimed to understand their experiences of these interventions. ⋯ Job demands simultaneously necessitate and restrict the provision of adequate interventions to support well-being in the ED. These demands need to be addressed as part of wider organisational change including the provision of self-care facilities and opportunities, protected time for facilitated reflection, high-quality and accessible learning opportunities for personal and professional development, training for staff delivering well-being interventions and positive role modelling by leaders.