Emergency medicine journal : EMJ
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Multicenter Study
Access block causes emergency department overcrowding and ambulance diversion in Perth, Western Australia.
Access block refers to the situation where patients in the emergency department (ED) requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame. We systematically evaluated the relationship between access block, ED overcrowding, ambulance diversion, and ED activity. ⋯ Reducing access block should be the highest priority in allocating resources to reduce ED overcrowding. This would result in reduced overcrowding, reduced ambulance diversion, and improved ED waiting times. Improving hospital inpatient flow, which would directly reduce access block, is most likely to achieve this.
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Multicenter Study
Impact of the Department of Health initiative to equip and train acute trusts to manage chemically contaminated casualties.
Before 1999, there was no national model or standard doctrine for managing casualties from chemical incidents in the UK. A Department of Health (DoH) initiative to prepare the National Health Service (NHS) for chemical incidents was launched in the same year. This led to the distribution of an NHS standard chemical personal protective equipment suit (CPPE) together with a new single half day training package (Structured Approach to Chemical Casualties (SACC)) in 2001. ⋯ Problems with the design and deployment of the CPPE, together with training difficulties have been fed back into the planning and development process.