Emergency medicine journal : EMJ
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Multicenter Study
Reliability and validity of the Manchester Triage System in a general emergency department patient population in the Netherlands: results of a simulation study.
To assess the reliability and validity of the Manchester Triage System (MTS) in a general emergency department patient population. ⋯ Inter-rater reliability is "moderate" to "substantial" and test-retest reliability is high. The reliability of the MTS is not influenced by nurses' work experience. Undertriage mainly occurs in the MTS categories orange and yellow. The MTS is more sensitive for children who need immediate or urgent care than for other patients in the emergency department.
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Multicenter Study Comparative Study
Emergency department staffing in England and Wales, April 2007.
To determine medical and nursing staffing levels in emergency departments in England and Wales. ⋯ There is great variability in staffing numbers in similar-sized departments, and most departments are understaffed in comparison with the recommendations of the British Association for Emergency Medicine to achieve the 4 h target at the 90% level.
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Multicenter Study Comparative Study
Incidence and causes of critical incidents in emergency departments: a comparison and root cause analysis.
To investigate the incidence of critical incidents in UK emergency departments (EDs) and to compare the root causes of such incidents between different EDs. ⋯ Critical incidents occur frequently in EDs. There are significant differences, as well as common themes, in the causes of these critical incidents between different EDs.
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Multicenter Study
Debriefing after failed paediatric resuscitation: a survey of current UK practice.
Debriefing is a form of psychological "first aid" with origins in the military. It moved into the spotlight in 1983, when Mitchell described the technique of critical incident stress debriefing. To date little work has been carried out relating to the effectiveness of debriefing hospital staff after critical incidents. The aim of this study was to survey current UK practice in order to develop some "best practice" guidelines. ⋯ Little is currently known about the benefits of debriefing hospital staff after critical incidents such as failed resuscitation. Debriefing is, however, widely practised and the results of this study have been used to formulate some best practice guidelines while awaiting evidence from further studies.
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Randomized Controlled Trial Multicenter Study
Mitigation of pain during intravenous catheter placement using a topical skin coolant in the emergency department.
Although intravenous (i.v.) line placement is a common procedure in the emergency department (ED), it is an uncomfortable experience for many patients. Topical analgesic agents are rarely used because they have long onsets of action and thereby cause unacceptable treatment delays. Cryoanaesthesia, the use of cooling agents to reduce pain, has been recognised for many years as a potential pain management strategy. The purpose of this study was to determine whether an instantaneous topical skin coolant spray reduces patient's pain during i.v. cannulation and represents a feasible alternative for cutaneous analgesia in the ED setting. ⋯ Our study failed to detect a difference in pain perception resulting from the pre-procedural application of a skin coolant associated with i.v. placement in the ED setting.