Emergency medicine journal : EMJ
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Emergency departments are one of the highest risk areas in health care. Emergency physicians have to assemble and manage unrehearsed multidisciplinary teams with little notice and manage critically ill patients. With greater emphasis on management and leadership skills, there is an increasing awareness of the importance of human factors in making changes to improve patient safety. ⋯ Therefore, there remains an educational gap that we need to fill before an emergency physician is equipped to function as a team leader and manager. This review will examine the lessons from aviation and how these are applicable to emergency medicine. Solutions to averting errors are discussed and the need for formal human factors training in emergency medicine.
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A short-cut review was carried out to establish whether ambulatory patients immobilized in an above knee plaster of paris cast and administered with a prophylactic dose anticoagulation with low molecular weight heparin; LMWH can benefit from a reduced risk of venous thromboembolism within the next 90 days. One randomised controlled trial was relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. The clinical bottom line is that despite limited data the use of LMWH thromboprophylaxis appears to be effective at reducing the incidence of VTE in these patients.
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Consultant based delivery of emergency service is perceived to add value. This study aims to demonstrate the impact of such a service model based on consultant working in a UK emergency department. ⋯ A consultant based service delivery offers many advantages. These cannot be matched by either junior or middle grades. This would be in addition to the consultants' supervisory role. Consultant expansion is urgently required to achieve this sustainably. A further study evaluating the cost benefits of this service model is now underway.