European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
The role of the emergency medicine resident using the Alvarado score in the diagnosis of acute appendicitis compared with the general surgery resident.
To compare the accuracy of diagnosing appendicitis between emergency medicine residents using the Alvarado score and general surgery residents using ultrasonography and their clinical provision. ⋯ There was no statistical difference between the emergency medicine residents using the Alvarado score and the general surgery residents in terms of suspecting the diagnosis of appendicitis.
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A case of open irreducible dislocation of the interphalangeal joint of the thumb with interposed flexor pollicis longus tendon and palmar plate with sesamoid bone is described.
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Ambulance paramedics have been practising in North Ayrshire for some time. The aim of this study was to determine the range and number of procedures that are undertaken by paramedics, and whether they are performed in accordance with standard operating procedures. ⋯ Paramedic exposure to extended skills is low in this region, leading to concerns about advanced skills retention. Paramedics can administer drugs appropriately according to protocol. Increasing paramedic experience, possibly augmented by feedback via audit, may be influencing paramedic decision making.
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In the past two decades, emergency physicians have increasingly looked beyond their national borders to examine how emergency medicine is practised elsewhere in the world. A major result of their efforts is international emergency medicine, which can be defined as the area of emergency medicine concerned with the development and delivery of emergency medical care in the world. Several international trends are currently occurring in emergency medicine, including an increasing number of venues for information exchange, the spread of emergency medicine practice guidelines, an increasing number of international collaborations, and an increasing number of transnational special interest groups in emergency medicine. ⋯ Multiple challenges await those involved in international emergency medicine, including the need for internationally accepted definitions, a 'systems approach' to analysing emergency medicine systems, and more useful and affordable information. A related challenge is the need for effective consensus-based processes, including international standardization processes. Many of these challenges may be met through the effective leadership of international emergency medicine organizations.