Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Sep 2005
Multicenter StudyManagement of suspected scaphoid fractures in accident and emergency departments--time for new guidelines.
The objectives of this work were to assess the clinical knowledge of clinicians in the accident and emergency (A&E) departments in England & Wales and evaluate the current trend for the acute management of radiologically normal, but clinically suspected, fractures of the scaphoid. ⋯ The clinical knowledge and the management of suspected scaphoid fractures in A&E are unsatisfactory. We, therefore, suggest that the dissemination of up-to-date guidelines could help to educate clinicians to provide better care to the patients.
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Ann R Coll Surg Engl · Jul 2005
A maximally sensitive clinical decision rule to reduce the need for radiography in mandibular trauma.
To identify clinical symptoms and signs that exclude the presence of mandibular fracture in patients presenting with mandibular trauma and thus devise a clinical decision rule that will rule out the need for radiography in some patients. ⋯ A simple decision rule is presented that can be used to exclude the need for radiography in a subset of patients with mandibular trauma.
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Ann R Coll Surg Engl · Jul 2005
ReviewDoes earlier detection of critically ill patients on surgical wards lead to better outcomes?
Patients at risk of catastrophic deterioration are often identified too late. Delayed identification of sick patients and delayed referral to intensive care units might be associated with poor outcomes. The goal of the review is to assess the potential impact of systems that enable early detection of critically ill surgical patients. ⋯ The literature about Critical Care Outreach and Medical Emergency teams is characterised by methodological weaknesses. However there is a common suggestion that early detection might improve outcome of critically ill surgical patients.
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Ann R Coll Surg Engl · Jul 2005
An evaluation of operative training lists for senior house officers in a district general hospital.
To address concerns about reduced opportunities for operative training, a programme of training operating lists for senior house officers was established. The entire patient pathway was used as a learning resource so that training was offered in a range of areas including development of knowledge, communication skills and attitudes as well as operative technique. ⋯ There is an imperative to find new, efficient ways to train surgeons. Dedicated training operating lists with an appropriately controlled case-mix can both address a service need and provide a high intensity learning experience.