Articles: emergency-services.
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To assess the feasibility and the validity of an audit using major trauma outcome study methods in an accident and emergency department. ⋯ Audit of management of major injuries should be carried out by every hospital, and the methodology of the major trauma outcome study is an excellent system for carrying out such audit. The study of all patients admitted with trauma requires appreciable extra resources, but most hospitals should be able to monitor the care of seriously injured patients as their numbers are much fewer.
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Randomized Controlled Trial Clinical Trial
The emergency department treatment of dyspepsia with antacids and oral lidocaine.
The treatment of dyspepsia in the emergency department often consists of antacid in combination with viscous lidocaine, even though the specific etiology of the pain is frequently unknown. The efficacy of lidocaine as a component of symptomatic therapy was evaluated in a randomized, patient-blinded protocol. Patients presenting to the ED with dyspeptic symptoms were randomized to receive 30 mL of antacid (Mylanta II), or 30 mL of antacid plus 15 mL of 2% viscous lidocaine (GI cocktail). ⋯ Assessment of pain relief using a five-point rating scale also indicated greater relief with GI cocktail therapy compared with antacid alone (P = .004). No adverse effects were noted with either treatment. We conclude that a single dose of antacid and viscous lidocaine provides a significantly greater degree of immediate pain relief than antacid alone in patients with dyspepsia.
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Observation units (OBS) are becoming a common addition to the emergency department. The diagnostic and socioeconomic categories of patients admitted to the OBS unit resemble those seen in the emergency department. There are many advantages and disadvantages in establishing such a unit. Although OBS units provide improved patient care, current difficulties in reimbursement may delay their widespread acceptance.