International emergency nursing
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To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals. ⋯ Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies.
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Management of battlefield casualties in Iraq and Afghanistan has seen considerable development in damage control resuscitation, which aims to address the risk of haemorrhage, initially due to mechanical damage; and thereafter due to the development of life-threatening coagulopathy. Damage control resuscitation combines a variety of techniques, such as the use of the combat application tourniquet and novel haemostatics, through to ground-breaking developments in transfusion protocols. ⋯ Meticulous trauma audit is included in this process and has allowed for rapid translation of knowledge into practice. The main elements of this doctrine are described.