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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Bilateral hip dislocation occurring as a result of trauma is a rare condition. Simultaneous anterior and posterior traumatic dislocation of both hips is even more unusual. A case is reported of asymmetrical bilateral traumatic hip dislocation without an associated fracture of the pelvis or femur occurring in a young adult with no previous history of hip abnormality or ligamentous laxity. An unusual mechanism for this injury is also described.
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Cardiac myxomas have a wide range of clinical presentations. The patient in this case presented with chest and back pain gradually radiating to her legs. ECG demonstrated an acute myocardial infarct. In cases of apparent aortic dissection, other disgnoses such as myxoma embolisation should be considered.
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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.