Emergency medicine journal : EMJ
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There is no specific structured training programme for doctors working in prehospital care in the United Kingdom. In the West Midlands (UK) a structured supervised programme has been devised, which recruits medical undergraduates and provides an educational programme and practical experience leading to the successful completion of the Diploma in Immediate Medical Care and the status of an independent prehospital care practitioner. The training scheme has successfully produced a significant number of coctors who are now practising in the West Midlands and United Kingdom.
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A short cut review was carried out to establish whether an abdominal radiograph has clinical utility in the management of patients who claim to have swallowed drug filled packages. Twelve papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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In 1998, the New York State Department of Health released guidelines governing the provision of HIV post-exposure prophylaxis (HIV PEP) after adolescent and adult sexual assault. This study sought to examine the extent of HIV PEP provision in a New York City paediatric emergency department (ED) after the release of these guidelines. ⋯ This study advocates improved efforts to expedite HIV PEP provision in the ED, such as educating ED practitioners on its proper use, and making HIV PEP drugs available for direct dispense from the ED.
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To determine the timings of regional transfer for emergency neurosurgery and intensive care after severe head injury in children, and the effective operational range of a regional service. ⋯ Good evidence supporting the recommendation that acute neurosurgery for the evacuation of a haematoma within four hours of injury is still scarce. The timings of care after an accident suggest that this guideline is unworkable in regions covering areas with road distance travel times in excess of 45 minutes.