Emergency medicine journal : EMJ
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Ambulance clinicians use pre-alert calls to inform emergency departments (EDs) about the arrival of critically ill patients. However, there is variation in guidance between local ambulance service policies in terms of what should be pre-alerted and how pre-alerts should happen. We conducted a national online survey to understand the use of ambulance pre-alerts and to inform recommendations for practice and guidance. ⋯ We identified variation in pre-alert processes and practices that may result in uncertainty and challenges for ambulance clinicians providing time-critical care. Guidance and training on the use of pre-alerts may promote more consistent processes and practices.
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On-scene improvised and interim decontamination protocols in the Initial Operational Response to chemical incidents aim for rapid intervention to minimise injury before specialist capabilities arrive. This study examines the effectiveness of UK improvised and interim protocols conducted in sequence. ⋯ This research supports current practice of starting decontamination as soon as possible after chemical exposure and highlights the importance of implementing interim decontamination following improvised decontamination.
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Underutilisation of thrombolysis is a major problem in patients with stroke in Bangladesh as patients do not arrive within the therapeutic window due to delays in their way to emergency department. This study aims to assess the time delay from patients' symptom onset to arrival in the hospital and the factors that are associated with it. ⋯ Nearly 90% of the patients were late to arrive (>4.5 hours) at hospital and referral delay comprises the majority of the prehospital delay. Therefore, fast symptom recognition and the urgency of seeking healthcare as soon as symptoms appear should be the focus of public awareness efforts.