Emergency medicine journal : EMJ
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Multicenter Study
Coma and impaired consciousness in the emergency room: characteristics of poisoning versus other causes.
Unconscious patients represent a diagnostic challenge in the emergency room (ER), but studies on their characteristics are limited. The aim of this study was to investigate the frequency, characteristics and prognosis of different coma aetiologies with special focus on poisoning. ⋯ Poisoning was the most common cause of coma and young age was a strong predictor of this condition. The prognosis was favourable among poisoned patients but poor in the rest of the study population as a group.
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Multicenter Study
Influence of air ambulance doctors on on-scene times, clinical interventions, decision-making and independent paramedic practice.
Critics of air ambulance doctors question their contribution and believe on-scene time is prolonged. Two helicopter emergency medical service (HEMS) models operate in the West Midlands, one with doctors and the other without. A study was undertaken to compare on-scene time, management and decision-making between the two units. ⋯ Appropriately trained HEMS doctors provide advanced management and decision-making. This is without a negative effect on on-scene time, even when performing complex procedures. They are more likely to declare death or discharge patients at the scene, increasing the availability of this limited resource.