Emergency medicine journal : EMJ
-
To estimate the potential of alternative providers of care for minor health problems to reduce demands on emergency departments (EDs). ⋯ Although there appears to be considerable potential for minor conditions to be managed in settings other than the ED, our findings indicate that patients will continue to present these conditions to the ED. Patient perceptions of the urgency of their treatment need, and also the availability and capacity of alternative services may be offsetting their potential to substitute for the ED. Advice from other services may be contributing to demands on the ED.
-
Patients with symptoms of deep vein thrombosis (DVT) and pulmonary embolism (PE) commonly present to the emergency department (ED). The aim of this study was to assess the role of ischaemia-modified albumin (IMA) testing in the diagnosis of venous thromboembolism (VTE). ⋯ IMA testing cannot be used alone to diagnose DVT or PE, although there is a moderate association with PE in ED patients.
-
Paracetamol poisoning remains a major cause of morbidity and mortality. Clinical care of paracetamol poisoning depends on a range of patient variables and typically involves both medical and nursing care. An integrated care pathway (ICP) is a multidisciplinary management plan that incorporates guidelines and best practice to enhance care and documentation for a specific patient group. Paracetamol overdose is thus amenable to an ICP. ⋯ Implementation of an ICP for paracetamol poisoning significantly improved patient management and helped to standardise inter-professional decision making in this challenging patient group. This is likely to improve patient outcome.
-
The simplified motor score (SMS) is a three-point measure of traumatic brain injury (TBI) severity, which is easier to calculate than the 15-point Glasgow coma scale (GCS). Using a state trauma registry, the accuracy of the emergency medical services (EMS)-obtained SMS was compared with the GCS for predicting neurological outcomes and mortality. ⋯ In a state trauma registry including both trauma and non-trauma centres, the EMS-obtained SMS performs as well as the 15-point GCS.