Emergency medicine journal : EMJ
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Multicenter Study
Management of whiplash injuries presenting to accident and emergency departments in Wales.
To assess the use of soft collars for whiplash injuries presenting to Welsh accident and emergency departments and compare with recommended treatment as suggested by other literature. ⋯ The study recommends treatment protocols for whiplash injuries prescribing regular analgesia, early home exercises with the help of an advice sheet, and physiotherapy if symptoms persist.
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Multicenter Study
National audit of emergency department child protection procedures.
To assess the compliance with national guidelines on child protection procedures and provision of paediatric services in major English emergency departments. ⋯ Many nationally agreed recommendations are being met, but there is a need for improved training, increased numbers of specialised staff, and improved communication between professionals. There is considerable variation in practice between departments.
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Multicenter Study
Barking up the wrong tree? A survey of dog bite wound management.
Several trials have been published examining the role of antibiotics in dog bite wound management. A meta-analysis of these suggests that there is very little benefit to routine antibiotic prescription in these patients. All papers however incorporated rigorous wound care regimens involving large volume irrigation. ⋯ Management of dog bite wounds would not seem to be evidence based in most departments in this sample.
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Multicenter Study
Descriptive epidemiology of adult critical care transfers from the emergency department.
To describe the nature, frequency, and characteristics of adult critical care transfers originating from the emergency department (ED). ⋯ Trauma is the most common reason for transfer of the critically ill adult from the ED. A significant number of patients are transferred, however, with medical and surgical conditions and for non-clinical reasons. There continues to be problems with the quality of care that these patients receive. Emergency medicine clinicians must be actively involved in the development of regional critical care systems as a significant proportion of all critically ill adults transferred originate from the ED.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Computer assisted assessment and advice for "non-serious" 999 ambulance service callers: the potential impact on ambulance despatch.
To investigate the potential impact for ambulance services of telephone assessment and triage for callers who present with non-serious problems (Category C calls) as classified by ambulance service call takers. ⋯ The findings indicate that telephone assessment of Category C calls identifies patients who are less likely to require emergency department care and that this could have a significant impact on emergency ambulance dispatch rates. Nurses were more likely than paramedics to assess calls as requiring an alternative response to emergency ambulance despatch, but the extent to which this relates to aspects of training and professional perspective is unclear. However, consideration should be given to the acceptability, reliability, and cost consequences of this intervention before it can be recommended for full evaluation.