Emergency medicine journal : EMJ
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A very rare case is presented of a woman with subclavian vein thrombosis that resulted from a fragment of her fractured clavicle impinging on the subclavian vein.
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Patients who fail to wait for medical assessment in the emergency department (ED) have been referred to in the international literature as "did not wait" (DNW) or "left without being seen" (LWBS) patients or, indeed, simply as "walkouts". This is taken as a performance indicator internationally. In common with many countries, Ireland has very considerable problems in the delivery of ED care due largely to inadequate resources and the inappropriate use of EDs as holding bays for admitted patients. This is the first study of this size to profile the DNW phenomenon in Ireland. ⋯ Failure to provide the service in a timely manner gives rise to patients leaving without receiving the medical assessment they came to obtain. This is a serious clinical problem and puts both those requiring care and those providing it at risk of adverse outcomes.
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The purpose of this study was to identify independent factors that can be used to predict whether febrile neutropenic patients who appear healthy at presentation will develop subsequent complications, using variables that are readily available in the emergency department (ED). ⋯ Platelet count, CRP and pulmonary infiltration on chest x ray at presentation could be used to identify febrile neutropenic patients who will develop complications, and these factors may be useful in making treatment-related decisions in the ED.
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Effective preparedness for pandemic influenza necessitates acquisition and maintenance of vital equipment and infrastructure. The aim of this study was to investigate the relationship between the level of hospital preparedness relating to infrastructure and equipment and performance of the hospital in an avian flu drill. ⋯ This study has identified benchmarks of infrastructure and equipment required for managing a pandemic influenza event and evaluating the level of emergency preparedness of the hospital. The significant relationship between maintaining stockpiles of antiviral medications for patients and staff and performance in an avian flu drill emphasises its importance in the process of maintaining emergency preparedness for a pandemic influenza outbreak.
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This article follows our description of generic qualitative approaches, focusing on the specific designs of ethnography, grounded theory and phenomenology. Distinguishing features are described, including methodological approaches and methods for enhancing rigour. The use of these designs in emergency care is unusual but informative, and important work has been produced. Whether used in a pure or applied manner, it is likely that such approaches will add to our understanding of the emergency world.