Emergency medicine journal : EMJ
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Comparative Study
Impact of the new UK licensing law on emergency hospital attendances: a cohort study.
To assess the effect of the new UK alcohol licensing law on overnight attendances to the emergency department. ⋯ Overnight alcohol related emergency attendances to St Thomas' hospital increased after the introduction of new alcohol licensing legislation. If reproduced over longer time periods and across the UK as a whole, the additional burden on emergency care could be substantial.
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To establish whether UK emergency physicians could reliably perform focused ultrasound of the abdominal aorta in patients with suspected abdominal aortic aneurysm (AAA). ⋯ Emergency ultrasound scanning by UK emergency physicians has high sensitivity and specificity for identifying AAA, consistent with international experience.
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To determine the extent to which the recommendations of the alcohol harm reduction strategy for England and the Choosing Health white paper for the provision of screening and brief interventions for hazardous and harmful drinkers have been adopted by accident and emergency departments. ⋯ Although departments may be willing to address hazardous alcohol consumption, the low numbers of departments utilising formal screening tools suggests that patients who may benefit from help or advice remain undetected.
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To clarify the use of blood alcohol concentration (BAC) in the emergency department resuscitation room, by comparing it with a subsequent alcohol questionnaire and by surveying patients' attitudes to BAC testing. ⋯ Use of BAC testing complements later questionnaire screening to identify alcohol misuse in patients initially brought to the emergency department resuscitation room, providing results are fed back to the patient. Potential ethical, judicial and insurance concerns should not prevent the use of BAC when judged to be in the patient's best interest.
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Ambulance crews usually have just one opportunity to convey information about their patients to emergency department (ED) personnel. ED staff receiving patients from ambulance crews will naturally be focussed on their own initial assessment of the patient, which often distracts them from listening carefully to the ambulance crew's handover. Important information may be lost after the ambulance crew leaves. ⋯ Communications training, clinical team leadership and team discipline must support the communication process between ambulance crews and the ED team to ensure that important pre-hospital information is not lost or misinterpreted. Electronic patient report forms are currently under development and may provide a partial solution for the transfer of accurate pre-hospital information to ED staff.