Emergency medicine journal : EMJ
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Comparative Study
Comparison of arterial and venous pH, bicarbonate, PCO2 and PO2 in initial emergency department assessment.
To determine the agreement between arterial and venous samples in a pathologically diverse patient population presenting at an emergency department (ED) with a view to obviating the need for arterial blood gas (ABG) analysis in initial ED evaluation. ⋯ Venous blood gas analysis for pH, bicarbonate and Pco(2) may be a reliable substitute for ABG analysis in the initial evaluation of an adult patient population presenting to the ED.
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Comparative Study
Use of the prehospital ECG improves door-to-balloon times in ST segment elevation myocardial infarction irrespective of time of day or day of week.
The use of the prehospital electrocardiogram (ECG) to identify patients with ST-segment elevation myocardial infarction (STEMI), coupled with a centralised system to alert the cardiac catheterisation team in preparation for prompt intervention, has been shown to reduce door-to-balloon times (DBT) effectively. A confounding variable in prolonging the recommended 90 min DBT is the time of day or day of the week of patient presentation. We postulated that use of the prehospital ECG, coupled with an emergency department initiated "Cath Alert" system, could neutralise DBT delays related to time of day or day of week. ⋯ Variables such as time of day and mode of presentation have an impact on achieving currently recommended DBT in patients with STEMI. With the addition of each prehospital variable in succession-that is, arrival by emergency medical services, Cath Alert system, and the prehospital ECG-the DBT can be progressively shortened and the adverse "off hour effect" nullified.
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Comparative Study
Impact of the new UK licensing law on emergency hospital attendances: a cohort study.
To assess the effect of the new UK alcohol licensing law on overnight attendances to the emergency department. ⋯ Overnight alcohol related emergency attendances to St Thomas' hospital increased after the introduction of new alcohol licensing legislation. If reproduced over longer time periods and across the UK as a whole, the additional burden on emergency care could be substantial.
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To establish whether UK emergency physicians could reliably perform focused ultrasound of the abdominal aorta in patients with suspected abdominal aortic aneurysm (AAA). ⋯ Emergency ultrasound scanning by UK emergency physicians has high sensitivity and specificity for identifying AAA, consistent with international experience.
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To determine the extent to which the recommendations of the alcohol harm reduction strategy for England and the Choosing Health white paper for the provision of screening and brief interventions for hazardous and harmful drinkers have been adopted by accident and emergency departments. ⋯ Although departments may be willing to address hazardous alcohol consumption, the low numbers of departments utilising formal screening tools suggests that patients who may benefit from help or advice remain undetected.