Emergency medicine journal : EMJ
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Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.
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To investigate the clinical characteristics and outcomes of adults with occult bacteraemia and the clinical impact of appropriate antibiotics. ⋯ For adults with occult bacteraemia, a lower severity of illness and death rate than those of bacteraemic patients hospitalised for ED visit could be demonstrated, demonstrating the importance of appropriate antibiotic therapy.
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Comparative Study
Emergency medical admissions, deaths at weekends and the public holiday effect. Cohort study.
To assess whether mortality of patients admitted on weekends and public holidays was higher in a district general hospital whose consultants are present more than 6 h per day on the acute medical unit with no other fixed clinical commitments. ⋯ Patients admitted as emergencies to medicine on public holidays had significantly higher mortality at 7 and 30 days compared with patients admitted on other days of the week.
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Comparative Study
Influence of the Manchester Triage System on waiting time, treatment time, length of stay and patient satisfaction; a before and after study.
To compare waiting time, treatment time, length of stay (LOS), patient satisfaction and distribution of waiting times over levels of urgency before and after the implementation of the Manchester Triage system (MTS) at an emergency department (ED). ⋯ Implementing MTS on its own is not sufficient to improve efficiency and quality of EDs. More complex interventions including process redesigning that targets various groups of ED patients should be evaluated in the future by using rigorous research designs for quality improvement of EDs.
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Observational Study
Evolved design makes ThoraQuik safe and user friendly in the management of pneumothorax and pleural effusion.
We have previously described the utility of ThoraQuik, a device designed to be fit for purpose for aspirations of pneumothorax and pleural effusions. We evaluated the safety, efficacy and operator handling of the evolved prototype, ThoraQuik II, which has a lesser profile and a spring loaded Veres needle for added safety. ⋯ Our study found the use of ThoraQuik II to be safe and easy in draining pneumothorax and pleural effusions. The changes to ThoraQuik II made it more user friendly.