Emergency medicine journal : EMJ
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Mountain Rescue Teams in Snowdonia endeavour to use pelvic splints as per JRCALC guidelines. However, mountain casualties with major mechanisms of injury are often found in precarious locations where application of splints is challenging. We wondered whether the pelvic fractures seen in mountain casualties are of the type likely to benefit from splintage. ⋯ Pelvic fractures are uncommon in Snowdonia mountain casualties, and, in survivors, the vast majority are stable (92%, cf. 55% in urban casualties). Severe pelvic disruption was seen only in casualties declared dead at scene. Only one casualty in a nine-year period had a pelvic fracture that might benefit from a pelvic splint. Our data suggests that application of pelvic splints need not be considered a high priority in mountain casualties, especially in precarious locations.
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During 2011/12, East Midlands Ambulance Service (EMAS) received 776,000 emergency 999 calls of which 36% (277,000) did not require transportation to hospital. Inappropriate calls can be due to public misunderstanding of when it is appropriate to ring 999. NHS 111 is an alternative free telephone service that enables the public to access health care advice or resources when the matter is urgent but not a 999 emergency. However knowing which service to telephone is not always easy and such a decision can be particularly difficult for older people as symptom presentation across complex co-morbidities can be atypical. A mixed method scoping project was carried out to explore the understanding, use and experiences of emergency (999) and urgent services (NHS 111) by older people aged 65 and over. Here, we report findings from the qualitative workstream. ⋯ Developing a greater understanding of how older people decide to contact a service would support future policy and practice implementation. If the remit of a service is unclear and accompanying publicity confusing, older people will continue to dial 999.
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In 2004 The National Institute for Health and Care Excellence (NICE) recommended in that ambulance services should carry Single Dose Activated Charcoal (SDAC) as an antidote to self-poisoning. A survey of ambulance services conducted a year later found a strong reluctance by services to carry the medication. As a result of a research project supporting the recommendation of NICE the South Western Ambulance Service conducted a six month trial of SDAC in two of its zones. ⋯ Time on scene where SDAC was offered was 20 minutes and 24 seconds compared with 23 minutes and 26 seconds where SDAC was not offered. Vomiting post administration occurred in only 11% of cases and crews reported no problems encountered in managing patients. Concerns of ambulance services in 2005 of prolonged on-scene times, poor take-up and time required to clean ambulances appear unfounded.