Emergency medicine journal : EMJ
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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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To determine opinion in relation to prioritisation of topics within the clinical curriculum of the College of Emergency Medicine. ⋯ Application of a consensus methodology incorporating free text and Likert scales allows expert opinion to be generated in relation to curricular prioritisation. This helps shape the format and educational utility of the specialty curriculum.
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The Manchester Triage System (MTS) is a 5-point triage scale used to triage patients presenting to the emergency department. It was introduced in the UK in 1996 and is now widespread, especially in Europe, and has been in use in our hospital since 2000 via a computerised protocol. A study was undertaken to determine whether the subgroups created by the application of MTS have different propensities for indirect triage outcomes such as death in the A&E department or being admitted to hospital. ⋯ The MTS provides information that extends beyond its immediate usefulness as a prioritisation mechanism. It is a powerful tool for distinguishing between patients with high and low unadjusted risk of short-term death as well as those who will stay in hospital for at least 24 h and those who will return home. Its discriminatory power is not equal for medical and surgical specialities, which may be linked to the nature of its inbuilt discriminators.
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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.