Emergency medicine journal : EMJ
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To examine three opinions voiced by nightshift emergency department (ED) staff. First, that a significant proportion of adult patients arriving by emergency ambulance lack a clear indication for emergency transport. Second, that at night a high proportion of ambulance arrivals are drunk, abusive or leave without treatment. Third, that at night a high proportion of ambulance arrivals have been assaulted or have deliberately harmed themselves. ⋯ The majority of ambulances were called appropriately; however, there remains a significant proportion who could travel by other means. A high proportion of ambulance arrivals between midnight and 05:00 hours were intoxicated, abusive or victims of assault. This supported staff's perception that such patients form a substantial proportion of departmental workload at night.
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Scalp avulsion is a rare but severe injury and usually happens as an industrial accident. This report concerns a successful salvage in scalp avulsion resulting from hair entrapment in a rotating machine. Most of the literature on scalp avulsion has focused on the technique of scalp replantation, with few addressing preoperative evaluation and preparation in the emergency department. ⋯ Scalp avulsion is a threatening blood loss injury. Rapid cessation of bleeding, wound compression and aggressive fluid resuscitation are important. With adequate resuscitation, careful evaluation and replantation as soon as possible the outcome is usually acceptable.
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Comparative Study
Contribution of goal-directed ultrasonography to clinical decision-making for emergency physicians.
To determine the contribution of goal-directed right upper quadrant (RUQ) ultrasonography (US) on real-time decision-making of attending emergency physicians by evaluating their level of certainty for admission, surgery, medical treatment, additional laboratory and radiological investigations and discharge. ⋯ US performed by emergency department physicians affects the certainty of their decisions in patients presenting with RUQ pain. This effect is more evident on the decision to perform additional diagnostic studies and in patients about whom physicians are undecided.
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Letter Practice Guideline Guideline
Guidelines for difficult airway equipment in emergency departments.