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Archives of emergency medicine最新文献

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Current Practice of Emergency Medicine 当前急诊医学实践
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/EMJ.10.3.257
A. Redmond
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引用次数: 0
How well do doctors resuscitate patients with haemorrhagic shock? 医生如何抢救出血性休克患者?
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.135
P Diprose, R A Sleet
{"title":"How well do doctors resuscitate patients with haemorrhagic shock?","authors":"P Diprose,&nbsp;R A Sleet","doi":"10.1136/emj.10.3.135","DOIUrl":"https://doi.org/10.1136/emj.10.3.135","url":null,"abstract":"<p><p>Patients with haemorrhagic shock of all degrees present to accident and emergency (A&E) departments regularly. This study examined 43 such patients who presented to one department over a 14-week period. The adequacy of their fluid replacement was judged in comparison with Advanced Trauma Life Support (ATLS) recommendations according to the degree of shock they appeared to have on presentation. The study found that more training may be required on the appropriate recognition and treatment of haemorrhagic shock.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"135-7"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Atraumatic brachial plexopathy following intravenous heroin use. 静脉注射海洛因后的非创伤性臂丛病。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.209
P A Evans, H T Millington
{"title":"Atraumatic brachial plexopathy following intravenous heroin use.","authors":"P A Evans,&nbsp;H T Millington","doi":"10.1136/emj.10.3.209","DOIUrl":"https://doi.org/10.1136/emj.10.3.209","url":null,"abstract":"<p><p>A 32-year-old man presented to the accident & emergency (A&E) department complaining of an inability to use his left arm and shoulder. The previous day he had injected heroin intravenously into his left antecubital vein. Examination revealed signs of a left-sided brachial plexus lesion. There was no history or sign of trauma. Neurological investigation revealed motor and sensory loss compatible with a complete brachial plexus lesion. He exhibited a very rare condition, asymmetrical atraumatic brachial plexopathy, thought to result from an inflammatory cause, which not only affects the brachial, but also other plexi or individual nerves in the body and thought to be related to repeated intravenous use of heroin. This is a condition for which there is no specific treatment but which usually resolves spontaneously in the absence of continuing heroin misuse.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"209-11"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
The role of activity-related groups in assessing workload in the accident and emergency department. 与活动有关的小组在评估意外及急症科工作量方面的作用。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.212
P W Crone, M R Whitlock
{"title":"The role of activity-related groups in assessing workload in the accident and emergency department.","authors":"P W Crone,&nbsp;M R Whitlock","doi":"10.1136/emj.10.3.212","DOIUrl":"https://doi.org/10.1136/emj.10.3.212","url":null,"abstract":"<p><p>Workload of the Accident & Emergency (A&E) Department at Barnet General Hospital was studied over a 1-year period. All new patients were divided into Activity-Related Groups (ARGs). Doctor work hours, for the year, were calculated utilizing the ARGs. This provided an estimate of the minimum required staffing level. ARGs are a potentially useful tool in auditing workload of individual doctors and the department as a whole.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"212-5"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Aeromonas hydrophila infection of a scalp laceration (with synergistic gas-gangrene). 头皮撕裂伤的嗜水气单胞菌感染(伴增效性气性坏疽)。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.232
A Grant, C Hoddinott
{"title":"Aeromonas hydrophila infection of a scalp laceration (with synergistic gas-gangrene).","authors":"A Grant,&nbsp;C Hoddinott","doi":"10.1136/emj.10.3.232","DOIUrl":"https://doi.org/10.1136/emj.10.3.232","url":null,"abstract":"A 30-year-old man sustained a dirty irregular V-shaped laceration to the vertex of his scalp on diving head first into a freshwater pond. There was no associated injury or loss of conciousness. No fracture or foreign bodies were seen on the initial skull X-ray. The wound was cleaned and sutured at a nearby accident and emergency (A&E) department. Two days later he returned complaining of pain over the scalp wound. He was admitted to hospital and antibiotic treatment begun. Forty-eight hours later he was transferred to the local neurosurgical unit. By this time his scalp had become extensively cellulitic with surgical emphysema. The wound was oozing purulent material. He was pyrexial at 39 celsius, with cervical and occipital lymphadenopathy. He was neurologically intact. A CT head scan confirmed marked soft-tissue swelling of the scalp and face, with extensive sub-galeal air and foreign material. There was no skull fracture. (Fig. 1) At operation a thorough debridement was performed excising necrotic galea and periosteum to healthy margins. Post-operatively his chemotherapy included penicillin 2 g 4 hourly, gentamicin and metronidazole. Bacteriological culture indi-","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"232-4"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Emergency treatment of adder bites: case reports and literature review. 毒蛇咬伤的急诊治疗:病例报告及文献复习。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.239
D J Harborne
{"title":"Emergency treatment of adder bites: case reports and literature review.","authors":"D J Harborne","doi":"10.1136/emj.10.3.239","DOIUrl":"https://doi.org/10.1136/emj.10.3.239","url":null,"abstract":"<p><p>Five cases of adder bites are presented. The clinical effects and current recommendations for the treatment of adder bites are described based on a review of previously published literature. All adder bites, or snake bites of unknown species, should be observed for a minimum of 2 h. Those with no local swelling may be allowed home with appropriate antitetanus prophylaxis. Patients with local reaction or signs of systemic envenoming should be admitted for 48 h with ECG monitoring, and antivenom obtained. Indications and precautions for administration of antivenom are reviewed. Early antivenom treatment may reduce mortality and morbidity from adder bites.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"239-43"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Telephone advice in the accident and emergency department: a survey of current practice. 事故急诊科的电话咨询:现状调查。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.216
R J Evans, M McCabe, H Allen, T Rainer, P W Richmond
{"title":"Telephone advice in the accident and emergency department: a survey of current practice.","authors":"R J Evans,&nbsp;M McCabe,&nbsp;H Allen,&nbsp;T Rainer,&nbsp;P W Richmond","doi":"10.1136/emj.10.3.216","DOIUrl":"https://doi.org/10.1136/emj.10.3.216","url":null,"abstract":"<p><p>The objective of this study was to assess the standard of advice given by telephone by accident and emergency (A&E) departments following patients' enquiries. In order to do this patient enquiries were simulated and a telephone questionnaire was carried out. The study was carried out in 18 major and 16 minor A&E departments in Wales. Results achieved were that overall, correct telephone advice was given to 72 of 97 simulated patients (74%). Sixty calls were dealt with by the nursing staff (62%) who gave correct advice on 41 (68%) occasions. No A&E department had a formal policy nor provided staff training for handling patients' enquiries by telephone. It is concluded that A&E departments should train designated members of staff, preferably the triage nurse, who would formally deal with telephone enquiries requiring medical advice. There should be formal documentation of the enquiry and advice proffered as part of a departmental policy.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"216-9"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 26
Evaluation of whiplash injuries by technetium 99m isotope scanning. 锝99m同位素扫描评价颈部扭伤损伤。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.197
D Barton, M Allen, D Finlay, I Belton
{"title":"Evaluation of whiplash injuries by technetium 99m isotope scanning.","authors":"D Barton,&nbsp;M Allen,&nbsp;D Finlay,&nbsp;I Belton","doi":"10.1136/emj.10.3.197","DOIUrl":"https://doi.org/10.1136/emj.10.3.197","url":null,"abstract":"<p><p>Despite the frequency with which whiplash injuries present to accident and emergency (A&E) departments, there lacks an objective investigation to define the severity of the initial injury or the morbidity that may ensue. Following reports on the effectiveness of isotope bone scanning for soft tissue and ligament injuries a study was undertaken of isotope scanning of whiplash injuries. The objectives of the study were to isolate the anatomic site of the injury and to quantify the severity of the injury with relation to the concentration of isotope uptake and subsequent morbidity.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"197-202"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Forced hyperextension to the wrist. 手腕被迫过伸。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.261-a
A Dancocks, L Thean
{"title":"Forced hyperextension to the wrist.","authors":"A Dancocks,&nbsp;L Thean","doi":"10.1136/emj.10.3.261-a","DOIUrl":"https://doi.org/10.1136/emj.10.3.261-a","url":null,"abstract":"McQuiston T. A. C. (1936) Poisoning with sodium nitrite. Lancet 2, 1153-1154. Polson C. J. & Tattersall R. N. (1969) Clinical Toxicology 2nd Ed, pp. 109-116. Pitman Medical, London. Shesser R., Mitchell J. & Edelstein S. (1981) Methaemoglobinaemia from isobutyl nitrite preparations. Annals of Emergency Medicine 10, 262-264. Walley T. & Flanagan M. (1987) Nitrite induced methaemoglobinaemia. Postgraduate Medical Journal 63, 643-644.","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"261"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.261-a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nurse triage in theory and in practice. 护士分诊的理论和实践。
Archives of emergency medicine Pub Date : 1993-09-01 DOI: 10.1136/emj.10.3.220
S George, S Read, L Westlake, B Williams, P Pritty, A Fraser-Moodie
{"title":"Nurse triage in theory and in practice.","authors":"S George,&nbsp;S Read,&nbsp;L Westlake,&nbsp;B Williams,&nbsp;P Pritty,&nbsp;A Fraser-Moodie","doi":"10.1136/emj.10.3.220","DOIUrl":"https://doi.org/10.1136/emj.10.3.220","url":null,"abstract":"<p><p>'Nurse Triage' refers to the formal process of early assessment of patients attending an accident and emergency (A&E) department by a trained nurse, to ensure that they receive appropriate attention, in a suitable location, with the requisite degree of urgency. The benefits claimed for nurse triage include better patient outcomes, through clinical management reaching those in greatest need of it first. A recent study of nurse triage in a British A&E department failed to demonstrate the benefits claimed: patients undergoing triage were delayed, especially those in the most urgent groups. No differences were noted between the two study groups in levels of satisfaction with the A&E process. The results brought forth criticism from all quarters. In this paper the points made by the critics are considered, and an attempt to answer them is made.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"220-8"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 23
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