Emergency medicine journal : EMJ
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To characterise and forecast daily patient arrivals into an accident and emergency (A&E) department based on previous arrivals data. ⋯ The two separate arrival streams exhibit different statistical characteristics and so require separate time series models. It was only possible to accurately characterise and forecast walk-in arrivals; however, these model forecasts will still assist hospital managers at the case study hospital to best use the resources available and anticipate periods of high demand since walk-in arrivals account for the majority of arrivals into the A&E department.
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Pulmonary embolism (PE) is a common and potentially fatal condition. The case is presented of a young woman who presented to the emergency department with first-time seizures. ⋯ The purpose of this report is to highlight to the clinical community that PE can present in a varied fashion and that, because of this, its diagnosis can occasionally be delayed. Vigilance is advised and expert clinical acumen is needed in young non-smoking persons with previously normal respiratory physiology who present with signs and symptoms of respiratory compromise, irrespective of the predominant or masking presentation.
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Emergency department (ED) physicians face frequent decisions on whether to admit patients with congestive heart failure (CHF) or acute exacerbation of chronic obstructive pulmonary disease (COPD). This feasibility study evaluated the potential of a structured 3-minute walk test as a clinical decision tool for admission and correlated its performance with poor clinical outcomes. It also aimed to gather evidence and directions for the design of a multicentre study to derive clinical guidelines. ⋯ The 3-minute walk test is a non-resource intensive, simple procedure with applicability in most ED for discharge decisions in patients with cardiopulmonary conditions. Multicentre studies are being planned to validate these findings and establish guidelines for admission and discharge of patients with CHF or acute exacerbation of COPD.