Articles: emergency-services.
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One-third of accident and emergency (A & E) patients who deliberately take an overdose are not admitted to hospital, and this proportion is increasing. We conducted an audit of 300 case records of such patients from two different district health authorities in London. We found that only 4% of patients were assessed in the manner recommended by the Department of Health and 10% had no psychosocial assessment whatsoever. We recommend specific training, an assessment form, regular audit, and communication with the general practitioner.
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Multicenter Study Comparative Study
Review of the composition and use of trauma teams within the Trent Region.
The aim of the study was to find the existence, composition and working policies of trauma teams within the Trent Region. Data were obtained by postal survey. Despite many reports indicating a need for a unified multidisciplinary approach to trauma management, this study found that this approach was absent in many hospitals.
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Comparative Study
Management of minor head injuries in the accident and emergency department: the effect of an observation ward.
The management of 483 patients presenting with minor head injury to the accident and emergency (A&E) departments of two Scottish hospitals was studied prospectively. Such patients comprised 5.7 and 3.9% of the total attendances to each department. Of the 277 patients assessed in the former department, 83 (30%) fulfilled at least one of the currently accepted criteria for recommending admission to hospital and 49 (17.7%) patients were actually admitted. ⋯ However, significantly fewer, 10 (4.9%) patients, were actually admitted. The major relevant factor when comparing the two departments was the existence in the former of an observation ward. These results support the view that easy access to hospital beds is a major determinant of management in patients presenting with minor head injury to the A&E department and may be more influential than clinical findings.