Emergency medicine journal : EMJ
-
Severe acute headache is a common presenting symptom to an accident and emergency department. Spontaneous intracranial hypotension (SIH) is an increasingly recognised cause of these symptoms and has characteristic clinical and imaging findings. ⋯ Atypical presentations occur and severe neurological decline can rarely be associated with this condition. A review of five patients presenting recently to our institution with classical imaging findings together with a review of the literature is presented.
-
To review the causes of death in patients admitted via the emergency department (ED) who died within 7 days of admission and to identify any ways in which ED care could have been better. The study also aims to compare the diagnosis made in the ED and the mortality diagnosis. ⋯ The ED is playing a good role in the management of critically ill patients, with appropriate diagnosis and management in 82% of cases. Training of junior doctors is required to prevent occurrence of errors and thus preventable deaths, but all deaths are not preventable. New guidelines for sepsis management and management of undifferentiated clinical presentations are being introduced and we intend to audit the implications of new guidelines.
-
As trainee numbers and the geographical spread of training departments have increased, the model of weekly face-to-face teaching has come under strain because of long travel times. This has been compounded by a reduction in the total number of hours worked by trainees. Furthermore the traditional teacher centred educational programme has been challenged as unfit for purpose on grounds of both content and style. ⋯ The principles outlined in this paper are widely applicable and will be of interest to all clinical educators within the specialty, both within the UK and overseas.
-
We attempted to examine an outbreak of acute gastroenteritis among the staff of the emergency department of Glasgow Royal Infirmary. We specifically looked at the pattern of spread among staff, the estimated hours of sick time and the practicalities of applying standard hospital guidelines for infection control within the emergency department. ⋯ We hypothesise that the infection was introduced from the community on several occasions and was subsequently passed among staff within the department. Infection control measures designed for the inpatient setting can be partially applied to the emergency department. We felt the most useful measures would be early identification and isolation of infectious patients, barrier nursing, escalation of cleaning of the department and early investment in replacement staff to allow ill staff members to remain isolated at home and to prevent understaffing.