Journal of accident & emergency medicine
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Budgetary responsibility gives you more control. Take time to master the fine detail, ask questions of your management and finance colleagues about anything you do not understand (you will not lose face), and develop the skills of lateral thinking and creative accountancy. Even if your budget is repeatedly overspent do not take it personally, ensure that management are aware of it and have a good night's sleep. Do not worry about it.
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Comparative Study
Effectiveness of ambulance paramedics versus ambulance technicians in managing out of hospital cardiac arrest.
To determine the effectiveness of extended trained ambulance personnel (paramedics) for the management of out of hospital cardiac arrest. ⋯ There are marked short term survival advantages after cardiac arrest associated with paramedic care, but these probably diminish rapidly over time.
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Increasing firearms violence has produced much public disquiet in recent months and Liverpool has seen a particularly well publicized spate of shootings. This is a case report of an initially occult intracranial injury which illustrates the unpredictable nature of missile trauma and the importance of computerised tomography in all cases of gunshot injury to the head.
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Comparative Study
Paramedic interventions increase the rate of return of spontaneous circulation in out of hospital cardiac arrests.
To determine whether paramedic interventions increased the rate of return of spontaneous circulation in the victims of out of hospital cardiac arrest. ⋯ Out of hospital cardiac arrests presenting in VF are managed equally well by paramedics and technicians. However, in non-VF arrests there is a significantly increased rate of return of spontaneous circulation in those patients attended by paramedics.
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A case is presented in which prolonged resuscitation and rewarming was performed following post-rescue cardiopulmonary arrest in severe immersion hypothermia. The rescue and resuscitation techniques necessary to optimise outcome in such cases are described.