Emergency medicine journal : EMJ
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Multicenter Study
Emergency intubation: a prospective multicentre descriptive audit in an Australian helicopter emergency medical service.
To describe the safety profile of emergency airway management when performed by a prehospital team consisting of a doctor and a paramedic. Success rates, the incidence of difficult airways and the ability of prehospital doctors to determine a difficult airway are reported. ⋯ Well-trained doctor paramedic teams, utilising standardised operating procedures, can safely perform rapid sequence induction and ETI in the prehospital and emergency environment. However, prehospital doctors are not always able to anticipate a difficult airway. The complication rate was similar to that in hospital emergency departments and to that of other physician-led HEMS.
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Multicenter Study
Standards of practice in UK emergency departments before, during and after conscious sedation.
The agents used for conscious sedation are well known to have potentially serious complications. It is recommended that patients receiving them should be objectively monitored until it is deemed safe. An audit of our departmental practices led us to conduct a national questionnaire to determine how we compared with other units in the UK. ⋯ Certain practices were applied in most departments but none were universal, with most being subject to wide variation. The local results reflected this, suggesting that a variation may exist both within and between individual units.
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Multicenter Study
Understanding patient experience of out-of-hours general practitioner services in South Wales: a qualitative study.
In the light of recent changes in the structure and provision of out-of-hours service in the UK, there is a need to re-assess the quality of care. One way to assess the quality of care is through patient experience. ⋯ Users' views and expectations may be used to inform service design and improve services, but the data also indicated a need to address user expectations of services, for example by enhanced information provision. Any such interventions to improve patient experience of out-of-hours care will need to be evaluated.
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Multicenter Study
Derivation of a risk assessment tool for emergency department patients with sickle cell disease.
Sickle cell patients commonly present to the emergency department (ED). Identifying those requiring admission and those who can safely be discharged is difficult. It was hypothesised that ED variables predictive of 96-h adverse sickle cell patient outcomes are identifiable. ⋯ Those ED variables predictive of 96-h adverse sickle cell patient outcomes can be identified and combined into a risk score. Prospective validation is necessary before any clinical decision-making based on this score.
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Multicenter Study Comparative Study
Impact of helical computed tomography in clinically evident appendicitis.
To determine the utility of multidetector computed tomography (MDCT) in patients with clinically evident acute appendicitis and to compare the test characteristics of overall clinical impression, Alvarado scores, and MDCT in suspected appendicitis. ⋯ The performance of abdominal MDCT in patients with a high degree of clinical suspicion for acute appendicitis reduces the number of false positives and has the potential to reduce negative appendectomies.