Emergency medicine journal : EMJ
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Traumatic brain injury is one of the most common reasons for admission to hospital emergency departments. However, optimal diagnosis and treatment protocols remain controversial. The aim of this study is to assess whether a specific group of patients can be discharged from the hospital without 24-h neurological observation. ⋯ Standard 24-h observation may not be required for adult patients with single intracranial bleeds with maximum diameter less than 5 mm, without a history of inherited coagulopathy or anticoagulant therapy, platelet aggregation inhibitor therapy, intoxication or multiple associated injuries. The decision for discharging patients may be made from the clinical picture. This might help to spare hospital resources and reduce unnecessary hospitalisations.
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A case of amisulpride overdose is presented and its effect on prolonging the QT (corrected) interval is discussed. Amisulpride is used for the treatment of schizophrenia and part of its safety profile is that is has no effect on the QT interval in therapeutic doses. The efficacy of intravenous calcium in restoring the QT to normal is proposed.
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Little is known about how and when homeless people use the emergency department. It might be anticipated that attendances would increase in cold weather as homeless people seek possible shelter. The authors aimed to describe emergency department attendances by homeless people and determine whether ambient temperatures affect attendance rates. ⋯ We found no evidence to suggest that homeless people are more likely to attend the emergency department in cold weather. If anything, there was a small positive correlation between rate of attendances and daily temperature.