Emergency medicine journal : EMJ
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Early treatment is critical for successful intervention in acute stroke. The aim of this study was to describe delays in presentation to hospital and in the emergency department (ED) management of patients with acute stroke and to identify factors influencing these delays in an Italian urban hospital. ⋯ A substantial proportion of patients does not arrive at the ED in a suitable time for reperfusion therapy. Patients using the EMS have a shorter arrival delay. Approximately half of the patients with stroke are sufficiently aware of the urgency of this clinical condition to activate the emergency telephone system.
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How far is too far? Recent government policy and demographic growth have led to role changes within the professions in emergency care. Healthcare professionals have extended and expanded their scopes of practice to include duties outside their traditional role boundary. Nurses in particular are able to see and treat patients more independently. These expanded roles mean there is growing overlap between professional roles and responsibilities and one wonders-how far is too far? Where should role expansion cease? The aim of this research was to explore the perceptions of the professions on their current and future roles in emergency care. ⋯ Of genuine concern to the respondents was the lack of standardisation within the expansion of healthcare roles. In terms of "how far is too far", the respondents believed that greater clarification of training and scope of practice is required, enabling clinical roles to develop more consistently.
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To describe a prehospital thrombolysis (PHT) and expedited inhospital thrombolysis (IHT) programme in south-east Scotland using prehospital 12-lead ECG recordings transmitted by telemetry and autonomous paramedic-administered thrombolysis with decision support being provided by coronary care nurses. ⋯ Based on prehospital 12-lead ECG telemetry, it is possible for paramedics and CCU nurses to conduct live reperfusion decision-making in patients with STEMI, with resultant benefits in symptoms-to-thrombolysis time.
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Acute medical management is an important component of the Modernising Medical Careers (MMC) project which has recently been implemented in the UK. A web-based interactive course in acute medicine has been developed which complements the clinical teaching provided to senior medical students at the University of Glasgow. A study was undertaken to evaluate the teaching and assess the knowledge of acute medicine among final year medical students using an online questionnaire. ⋯ This approach to blended learning is popular with our medical students. Online evaluation has helped with curriculum development and, by identifying important areas of acute medicine teaching that can be improved, is feeding into our curriculum revision.