Emergency medicine journal : EMJ
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To examine the effect of fast track on emergency department (ED) length of stay (LOS). ⋯ ED fast track decreased ED LOS for non-admitted patients without compromising waiting times and ED LOS for other ED patients.
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Randomized Controlled Trial
Cuffed oropharyngeal airway (COPA) placement is delayed by wearing antichemical protective gear.
Airway management, the first step in resuscitation, may entail special difficulties in mass casualty situations, even in experienced hands. Of the available airway devices, the cuffed oropharyngeal airway (COPA) appears the easiest one to insert, allowing a hands-free anaesthesiologist. A study was undertaken to evaluate the success of airway control with COPA when anaesthetists wore either surgical attire or antichemical protective gear. ⋯ Antichemical protective gear slowed proper placement of COPA and its fixation compared with surgical attire. COPA may be a temporarily useful device in non-conventional settings, but functional reassessment is required when injured patients reach medical facilities.
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In the event of major incidents, neighbouring air ambulances can be used to assist. To assess the potential benefit of this cooperation, three fictitious major incidents were described to emergency service dispatch desks to assess the availability and response times for neighbouring air ambulances. ⋯ The costs of such schemes are minimal where air ambulances already exist. Ambulance services can use this type of scheme rapidly to place a comprehensive medical infrastructure for major incidents.
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To examine and explore factors that may influence the recording of vital signs in adult patients within the initial 15 min and again within 60 min of arrival in the "resuscitation" and "major" areas of the emergency department (ED). ⋯ Recording of vital signs was poor and unrelated to staffing levels or numbers of patients attending the ED. Failure to record patients' vital signs undermines strategies to detect and manage ill patients.
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Research within the European Union has shown international visitors to have a higher injury mortality than residents. Traffic accidents are the leading cause of injury-related death among overseas visitors and evidence suggests overseas visitors are at a greater risk of being involved in road traffic accidents than the resident population. Little information looks specifically at pedestrian injuries to overseas visitors. Pedestrian deaths account for 21% of all UK road deaths. ⋯ During the 7-year period studied, 61% of HEMS missions to overseas visitors involved a pedestrian being struck by a vehicle, compared with 16% of missions to UK residents. For HEMS missions, serious trauma to pedestrians is disproportionally more common among the visitor population to London.