Emergency medicine journal : EMJ
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To answer concerns related to implementation of the National Institute for Clinical Excellence (NICE) guideline on the management of head injury by determining the impact on the workload of a district general hospital. Increased computed tomography (CT) was of particular concern (cost, radiation risk, and delivery constraints). ⋯ This department has seen an increase in CT head requests since the implementation of the NICE guideline. This costs an extra 15,000 pounds sterling per 100 head injuries annually for this department, with an estimated 51.7 million pounds sterling burden for England and Wales. Further evaluation is required as there were only nine brain injuries in this audit population.
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Review Comparative Study
Best evidence topic report. Clopidogrel plus aspirin or aspirin alone in unstable angina.
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The Cape Triage Group (CTG) convened with the intention of producing a triage system for the Western Cape, and eventually South Africa. The group includes in-hospital and prehospital staff from varied backgrounds. ⋯ The CTS has been validated in several studies, and was launched across the Western Cape on 1 January 2006. The CTG would value feedback from readers of this journal, as part of the ongoing monitoring and evaluation process.
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To identify the key features of effective clinical supervision in the emergency department (ED) from the perspectives of enthusiastic consultants and specialist registrars. To highlight the importance of clinical supervision within emergency medicine, and identify obstructions to its occurrence in everyday practice. ⋯ The value of supervision extends to all patient presentations in the ED. The study raised questions concerning the appropriate attitudes and qualifications for supervisors. Protected supervisory time for those with trainees is mandatory, and must be incorporated within ED consultant job planning.
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The French word "trier", the origin of the word "triage", was originally applied to a process of sorting, probably around 1792, by Baron Dominique Jean Larrey, Surgeon in Chief to Napoleon's Imperial Guard. Larrey was credited with designing a flying ambulance: the Ambulance Volante. Baron Francois Percy also contributed to the organisation of a care system for the ongoing management of casualties. Out of the French Service de Santé, not only emerged the concept of triage, but the organisational structure necessary to handle the growing number of casualties in modern warfare.