Annals of emergency medicine
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This article describes the history and current status of the practice of hospital-based accident and emergency (A&E) medicine in the United Kingdom of Great Britain and Northern Ireland. Included are comments on training and certification, the operations of the typical A&E department, and developments in research and academics. Also included are the authors' thoughts on issues of future importance to A&E medicine. As transatlantic links at all levels become increasingly common in this dynamic specialty, we clarify unfamiliar terminology and practices for international readers.
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Comparative Study
Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures.
To compare patient and practitioner assessments of pain associated with commonly performed emergency department procedures and use of anesthetics before these procedures. ⋯ The most painful procedures for ED patients were nasogastric intubation, incision and drainage of abscesses, fracture reduction, and urethral catheterization. Although practitioners also identified these procedures as most painful, the correlation between patient and practitioner pain assessments in individual patients was highly variable. Overall use of anesthetics before these procedures was low. Practitioners should be attentive to their patients' individual anesthetic needs before performing painful procedures.
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Screening for intimate partner violence has been widely advocated in the health care setting, but efforts to assess effectiveness and ensure adequacy of universal screening are largely untested. We sought to identify barriers to screening of female emergency department patients for intimate partner violence during the first year of implementation of a screening protocol. ⋯ In this random sample of female patients, screening rates varied by severity of the patient's condition, type of presenting complaint, and presentation time.