Articles: emergency-services.
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A 42-year-old woman presented with the acute onset of bilateral blurred vision that occurred immediately after bending over. She denied pain or any other associated symptoms. ⋯ This case represents an atypical presentation of acute narrow-angle glaucoma, a true ophthalmological emergency. The pathophysiology and treatment options of this disease process are summarized.
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The response to major trauma in Britain has been demonstrated to be inadequate. One of the suggested approaches to tackling the problem has been the setting up of rapid response trauma teams at district general hospitals. ⋯ Numbers of patients were not sufficient to draw any firm conclusions, though no dramatic improvement in outcome was evident. Problems in setting up such a team are discussed.
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A retrospective trauma audit of 267 consecutive patients presenting to the resuscitation room of an accident and emergency department identified 107 (M = 0.73) patients with CNS predominant injuries in a period of 1 year. The mortality rate was 33 per cent. ⋯ Subsequent peer review agreed that death was preventable in 11 cases. The peer panel suggested that the lack of an on-site neurosurgical service may have affected the outcome of this group of patients adversely.
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All 7157 patients (55% men) admitted to the emergency room with chest pain or other symptoms indicative of acute myocardial infarction during a period of 21 months were registered consecutively. Chest pain was reported by 93% of the patients. ⋯ In patients with no suspected infarction (n = 2910), musculoskeletal (26%), obscure (21%) and psychogenic origins (16%) of the symptoms occurred most frequently. We conclude that few of the patients had an obvious infarction on admission, and that a musculoskeletal origin of the symptoms occurred most frequently in patients with no suspected infarction.