Emergency medicine journal : EMJ
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To estimate the potential of general practice, minor injury units, walk in centres and NHS Direct to reduce non-urgent demands on accident and emergency (A&E) departments taking into account the patient's reasons for attending A&E. ⋯ The increasing availability of alternative services offering first contact care for non-urgent health problems, is likely to have little impact on the demand for A&E services.
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To explore what lies behind repeated emergency department (ED) use, from the patients' own perspectives. ⋯ From their own perspectives, frequent ED visitors are in need of urgent care. It is particularly important to these patients that the personal meaning they attach to their symptoms is attended to and respected by the ED staff.
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Multicenter Study
Pre-hospital aspirin for suspected myocardial infarction and acute coronary syndromes: a headache for paramedics?
To ascertain the frequency with which paramedics follow protocols for the administration of aspirin to patients to whom an ambulance is called for chest pain associated with suspected ischaemic heart disease. ⋯ Aspirin has been shown to be beneficial after a myocardial infarction and for other acute coronary syndromes. However, variances in the proportion of patients with suspected ischaemic heart disease given aspirin in different ambulance services indicates the need for a re-emphasis on the importance of this treatment. A standard protocol for all UK ambulance services should be devised that minimises the number of contraindications to aspirin and otherwise requires its administration to all patients with acute coronary syndromes or suspected myocardial infarction. Regular, standardised audits of compliance should also be conducted and their results widely disseminated.