{"title":"Out-of-district attenders: the passing trade of an accident and emergency department.","authors":"G M Bryce, J D Houghton","doi":"10.1136/emj.10.3.172","DOIUrl":"https://doi.org/10.1136/emj.10.3.172","url":null,"abstract":"<p><p>The resources of accident and emergency (A&E) departments are often required to treat patients who are not within the catchment population of the local health authority. An assessment of workload caused by this particular group was carried out over a 2-month period at Northampton General Hospital which serves a population of 318,000. Details were collected and analysed on the patients' reason for attendance, investigations and treatment.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"172-6"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206867","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}
{"title":"Paediatric accident & emergency short-stay ward: a 1-year audit.","authors":"T F Beattie, P A Moir","doi":"10.1136/emj.10.3.181","DOIUrl":"https://doi.org/10.1136/emj.10.3.181","url":null,"abstract":"<p><p>A short-stay ward attached to the accident and emergency (A&E) department has opened recently. The development of this ward is described together with its operation over a 1-year period. Head injuries were the commonest reason for admission. Only 7% of children stayed longer than anticipated or were considered inappropriate admissions.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"181-6"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206869","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}
{"title":"Poisoning and Drug Overdose","authors":"M. Waters","doi":"10.1136/emj.10.3.258","DOIUrl":"https://doi.org/10.1136/emj.10.3.258","url":null,"abstract":"While reading this book I was on duty for the A&E department and looked up some of the more unusual conditions that presented that day. Brodie's abscess was not listed in the index and the only reference to osteomyelitis in children was one paragraph in a book of over a thousand pages. Fracture/dislocation of the ankle with an obvious threat to the viability of the overlying skin was not covered. There is an algorithm for treating fractures but no mention is made of the importance of preserving circulation to the skin in severe dislocations. The book generally covers the unusual, such as, environmental emergencies quite well but day to day emergencies suffer as they are given equal coverage to the more exotic. In summary this is an interesting book that is well-produced and contains some very well prepared and informative pieces. Overall, however, it does not provide enough information on the more common emergencies for it to be of daily use in an A&E department. Furthermore, it is written entirely for the North American market and many of its recommendations are clearly not applicable to British Practice. I will keep the book and use it for easy access to references on 'intermediate exotica'. It will not provide the department with an easily useable reference book nor provide myself with a definitive text on the rarer conditions that we occasionally see.","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 1","pages":"258 - 259"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64221432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Repeat deliberate self-harm: a link with childhood sexual abuse?","authors":"H M Yeo, W W Yeo","doi":"10.1136/emj.10.3.161","DOIUrl":"https://doi.org/10.1136/emj.10.3.161","url":null,"abstract":"The purpose of this study was to identify whether a past history of childhood sexual abuse is a risk factor for repeated Deliberate Self-Harm (DSH). The study was a 6-month prospective study of 178 patients responsible for 190 consecutive cases of DSH seen during a 3-month censoring period. Patients were identified by review of the in-patient and accident and emergency (A&E) records of all cases of DSH at the A&E department of a major teaching hospital. Patients with a history of childhood sexual abuse showed a marked clustering of four major risk factors for repeat DSH (unemployment, past deliberate self-poisoning, self-injury and psychiatric illness) and were significantly more likely to repeat DSH within the 6-month follow-up period.","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"161-6"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206865","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}
{"title":"Short-stay facilities in accident and emergency departments for children.","authors":"T F Beattie, J Ferguson, P A Moir","doi":"10.1136/emj.10.3.177","DOIUrl":"https://doi.org/10.1136/emj.10.3.177","url":null,"abstract":"<p><p>This paper assesses short stay ward facilities for children in the United Kingdom. The results of a postal questionnaire indicate that 50% of departments surveyed have a short-stay ward. Of these 25% admit small numbers of children. These are mainly children who have sustained trauma-related problems. The potential role of paediatric short-stay ward facilities is discussed.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 3","pages":"177-80"},"PeriodicalIF":0.0,"publicationDate":"1993-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.3.177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19206868","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}
{"title":"A study of patients referred from A&E for coroners post-mortem.","authors":"I G Kendall, S M Wynn, D N Quinton","doi":"10.1136/emj.10.2.86","DOIUrl":"https://doi.org/10.1136/emj.10.2.86","url":null,"abstract":"<p><p>A review of 179 autopsies was undertaken over a 1-year period to determine if clinically useful information was obtainable from coroners post mortems performed on patients referred from the A&E department. Fifty-six patients had undergone unsuccessful resuscitation. The leading causes of death were heart disease and trauma. Discrepancies between the diagnosis made during resuscitation and the cause of death found at autopsy were revealed especially in those dying from noncardiac causes. Iatrogenic trauma from resuscitation attempts occurred in a significant number of cases. It is suggested that review of selected Coroners post mortems should be part of departmental audit, with a view to improving clinical skills.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 2","pages":"86-90"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.2.86","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19315309","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}
{"title":"Radiological diagnosis of scaphoid fractures: are two views enough?","authors":"C Bola Taiwo, N D Grunshaw","doi":"10.1136/emj.10.2.112","DOIUrl":"https://doi.org/10.1136/emj.10.2.112","url":null,"abstract":"Standard radiological diagnosis of scaphoid fractures involves four views of the wrist PA, lateral and two obliques. This amount of irradiation may be unnecessary, and previous authors have claimed that two views, Stecher (1937) (PA with 300 angulation towards the elbow giving an elongated view of scaphoid) and lateral, are of equal, or better, diagnostic accuracy. This study was performed to test the authenticity of this claim.","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 2","pages":"112-6"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.2.112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19315302","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}
{"title":"Occult spinal cord injury sustained by high velocity automobile collision.","authors":"A Gee, J McLoughlin, S M Byrnes, G N Sibley","doi":"10.1136/emj.10.2.123","DOIUrl":"https://doi.org/10.1136/emj.10.2.123","url":null,"abstract":"Medical education, by necessity, frequently emphasizes the resuscitation and relief of life-threatening conditions in the severely injured patient. The increased use of seat-belt retraints has meant that high speed automobile collisions may not necessarily result in major external injury if the occupants are well supported (Dudley, 1986). In such instances, trauma may be sustained as a result of the spine and viscera continuing to move forward following impact. Examples of such injuries are mesenteric detachment of the gut, ruptured solid organs and distraction fractures of the lumbar spine (Dudley, 1986). A case history illustrating several features which may alert the attending clinician to the presence of underlying, initially occult, clinically significant injury is described.","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 2","pages":"123-7"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.2.123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19315305","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}
{"title":"What is the requirement for out-of-hours operating in orthopaedics?","authors":"M McKee, P Priest, M Ginzler, N Black","doi":"10.1136/emj.10.2.91","DOIUrl":"https://doi.org/10.1136/emj.10.2.91","url":null,"abstract":"<p><p>Recent reports have emphasized the need to reduce the amount of unsupervised surgery performed at night by junior doctors. However there is little guidance about when an operation must be performed urgently and when it can be postponed safely. This study describes the existing pattern of out-of-hours trauma and orthopaedic surgery in four hospitals and reports the views of a panel of surgeons and anaesthetists on the extent to which operating could be postponed until the following day. Operations at night are uncommon--a mean of 0.6 per night and occurring on only 40% of nights--though their frequency shows two-fold variation between hospitals. With certain assumptions it is estimated that up to a third of out-of-hours operations could be postponed safely to the following day. Further evaluation is required of those operations about which the panel failed to reach agreement. While most of the procedures undertaken at night are within the competence of a registrar, some require the direct involvement of a consultant.</p>","PeriodicalId":77009,"journal":{"name":"Archives of emergency medicine","volume":"10 2","pages":"91-9"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/emj.10.2.91","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19315310","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}
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
