Emergency medicine journal : EMJ
-
Multicenter Study Comparative Study
To lead or not to lead? Prospective controlled study of emergency nurses' provision of advanced life support team leadership.
In many emergency departments advanced life support (ALS) trained nurses do not assume a lead role in advanced resuscitation. This study investigated whether emergency nurses with previous ALS training provided good team leadership in a simulated cardiac arrest situation. ⋯ ALS trained nurses performed as well as ALS trained and non ALS trained emergency SHOs in a simulated cardiac arrest situation and had greater awareness of the potentially reversible causes of cardiac arrest. Thus if a senior or middle grade doctor is not available to lead the resuscitation team, it may be appropriate for experienced nursing staff with ALS training to act as ALS team leaders rather than SHOs.
-
The use of resuscitation formulae for burns is advocated for A&E departments. Much care is taken to calculate the percentage of the burn, but this is then multiplied by an approximate weight. How accurate is this figure and should it be more carefully measured? Forty two sets of case notes of patients with resuscitation sized burns were reviewed. ⋯ The majority have only stand on scales. Three departments have sit on scales; however, if they were assessing the weight of a patient who is unable to sit they would need to ask the patient, relatives, or simply guess. Investment in weighing equipment should be encouraged if resuscitation formulae are to have any place in the A&E management of burn patients.
-
Multicenter Study
Survey of attitudes of senior emergency physicians towards the introduction of emergency department ultrasound.
Emergency department ultrasound (EDU) is widely practised in the USA, Australia, parts of Europe, and Asia. EDU has been used in the UK since the late 1990s but as yet, few areas have established a practice. ⋯ Despite the vast majority of ED consultants being in favour of EDU, very few actually perform it on a regular basis or have had any formal training. Highlighted difficulties in EDU implementation included financial constraints, lack of support from radiology departments, and lack of formal training.
-
Multicenter Study
A review of emergency equipment carried and procedures performed by UK front line paramedics on paediatric patients.
In 1997 a review of paramedic practice upon adult patients in the UK found many inconsistencies and deficiencies in basic care. A follow up review in 2002 identified widespread improvement in provision of equipment and skills to provide basic and advanced life support.Paediatric care was not assessed in either review. The authors conducted this study to identify current standards of care in paediatric paramedic practice and areas of potential improvement. ⋯ Ambulance Trusts not meeting standards set out in the JRCALC guidelines must address their areas of deficiency. Failure to do so endangers children's lives and leaves Trusts open to criticism.
-
To describe the emergency department (ED) management of isolated mild traumatic brain injury (TBI) in the USA and to examine variation in care across age and insurance types. ⋯ Substantial ED resources are devoted to the care of isolated mild TBI. The present study identified deficiencies in and variation around several important aspects of ED care. The development of guidelines specific for mild TBI could reduce variation and improve emergency care for this injury.