Emergency medicine journal : EMJ
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Multicenter Study
Views regarding the provision of prehospital critical care in the UK.
There is a lack of consensus regarding the role for critical care in the prehospital environment in the UK. It was hypothesised that this related to differences in views and understanding among opinion leaders within influential prehospital care organisations. ⋯ Although there appears to be broad agreement among opinion leaders regarding the concepts underpinning existing prehospital critical care services, areas of contention are highlighted that may help explain the current lack of consensus. Cooperative efforts to assess the current demand and clinical evidence would assist in the creation of a joint consensus and allow effective future planning for the provision of prehospital critical care throughout the UK.
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To establish the current practice of emergency department (ED) management of syncope in the UK and Republic of Ireland. ⋯ The ED management of syncope patients in the UK and Republic of Ireland is varied. Only 18% of ED have specific guidelines for managing this difficult condition and only 18% have access to a specialist syncope clinic. A robust consensus UK syncope guideline is clearly required.
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Multicenter Study
Helicopter emergency medical system in a region lacking trauma coordination (experience from Tehran).
The helicopter emergency medical service (HEMS) has been working in Iran since 2000. The present study is the first prospective research to determine the epidemiological characteristics of injured patients transported by helicopter in Tehran. ⋯ This study shows that overtriage in HEMS (transportation of patients without severe injuries) and the long transportation time is mainly a result of not having a trauma system. The study has shown HEMS to be an effective and feasible option in countries with heavy traffic and no trauma system.
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Seat belt use can decrease the mortality rate associated with road traffic accidents (RTA). However, there is an increased risk of bowel perforations among seat belt wearers, possibly as a result of improper use. A case is reported of a female passenger who presented with an abdominal wall fistula 2 weeks after a RTA.