Emergency medicine journal : EMJ
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Sternal fractures cause considerable pain, and a proportion of patients require admission for analgesia. Local anaesthetic techniques have been used to reduce the pain from chest wall injuries and may reduce complications from these injuries. ⋯ This technique was recently offered to patients in the emergency department at the Royal Devon and Exeter Hospital, Exeter, UK, and the experiences of patients and doctors are reported. Findings from this first case series suggest that the technique seems to be effective, well tolerated and acceptable to patients.
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The decision by paramedics to alert a receiving hospital to the imminent arrival of a critically ill patient is currently based on the crew's clinical judgement. ⋯ Ambulance crews do not alert hospitals to critically ill patients adequately. The Modified Early Warning Score should be considered to be the basis of a prehospital tool to aid their decision.
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To describe the triage of patients operated for non-ruptured and ruptured abdominal aortic aneurysms (AAAs) before the endovascular era. ⋯ A multidisciplinary unified strategy resulted in a rapid throughput of patients with acute AAA. Rapid transport, diagnosis and surgery resulted in favourable hospital mortality. Despite the fact that nearly all the patients were operated upon, survival was favourable compared with published data.