Emergency Medicine Journal current issueHighlights from this issueWalter, D. Wed, 11 Jan 2012 15:30:57 -0800
This month we range from Politics to philosophy, from basic science to standards of care. There is a spread of material on the resuscitation of cardiac arrest and lots of pre-hospital care; triage at ‘front’ and ‘rear’, trauma transfer times, airway care in the field and even how to improve ambulance safety. The meaning of words In this month's editorial, Hughes (see page 90) shows how easy it is to become confused with the political language of the performance culture in UK Emergency Medicine and translates some into simple terms that can be understood! On a much simpler and certainly more fundamental level, Body and Foex (see page 91) consider the philosophical difference between pain and suffering. Do we see and try to manage the disease/injury or care for the patient? Try their thought experiments to find out. Real science Tura et al (see...
A&E quality indicatorsHughes, G. Wed, 11 Jan 2012 15:30:57 -0800
International readers may need reminding that in April 2011 a new set of clinical quality (A&E) indicators was introduced in the NHS in England to replace the previous 4 h waiting time standard, the new indicators providing a platform with which to measure the quality of care delivered in A&E departments in England. The indicators were developed by the national clinical director for urgent and emergency care, working with the College of Emergency Medicine, the Royal College of Nursing and informed patient representatives. At the beginning of October last year the government released data for May 2011, related to A&E attendances for that month and drawing on just over 1.4 million detailed records of attendances at major A&E departments, single specialty A&E departments (eg, dental), minor injury units and walk-in centres in England.1 Five indicators are reported:left department before being seen for treatment rate; re-attendance rate;...
Optimising well-being: is it the pain or the hurt that matters?Body, R., Foex, B. A. Wed, 11 Jan 2012 15:30:57 -0800
In recent years there has been a commendable focus on patient-centred medicine, with increasing attention being paid to the timely assessment and management of acute pain. 78% of patients who attend the emergency department report pain, the severity of which is often used to determine clinical priority at triage. Clinical guidelines are increasingly including the timely provision of appropriate analgesia as a clinical standard. Pain scoring has been widely adopted, causing pain to be considered as the ‘fifth vital sign’ by some. Interestingly, there remains little evidence to support the benefit of this approach for patients. The aim of this review is to explore some of the assumptions that made in defining and addressing ‘pain’, and to explore whether it is truly ‘nociception’ or ‘suffering’ that ought to be addressed. Through two thought experiments, it is demonstrated that the current approach to pain relies heavily on addressing ‘nociception’ but does little to address the ‘suffering’ that is undoubtedly they key determinant of well-being in patients. It is demonstrated that the current naturalistic approach risks neglecting many ‘non-nociceptive’ sources of suffering, including physical (eg, nausea, vertigo, dyspnoea, pruritus) and mental (anxiety, depression, fear, anger) symptoms. In the humane quest to relieve suffering, there is a clear need to examine current practice. Indeed, the philosophical enquiry presented even questions whether our culture risks overemphasising the importance of pharmacological analgesia and calls for emergency physicians to take a more holistic approach to meeting patient needs.
GruntDocPride is a Fall RiskGruntDoc Wed, 08 Feb 2012 16:00:22 -0000
Stick with it. I’m good at intubating (the procedure by which a tube is passed through the vocal cords into the trachea to assist ventilation). I’m not the world’s expert, and I haven’t written a book about it, but I know what I’m about. I was trained by people who knew what they were doing, [...]
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Last Known WWI Veteran Florence Green Dies at 110 – ABC NewsGruntDoc Wed, 08 Feb 2012 03:14:35 -0000
Florence Green never saw the front line. Her war was spent serving food, not dodging bullets. But Green, who has died at age 110, was the last known surviving veteran of World War I. She was serving with the Women’s Royal Air Force as a waitress at an air base in eastern England when the [...]
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FBI warns of threat from anti-government extremists | ReutersGruntDoc Tue, 07 Feb 2012 03:29:49 -0000
A fisking of a grossly awful article. (Reuters) – Anti-government extremists opposed to taxes and regulations pose a growing threat to local law enforcement officers in the United States, the FBI warned on Monday. These extremists, sometimes known as “sovereign citizens,” believe they can live outside any type of government authority, FBI agents said at [...]
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Interactive: Who Are the Uninsured in Texas?GruntDoc Tue, 07 Feb 2012 02:18:39 -0000
Nearly a quarter of the Texas population lacked health insurance in 2010, according to the most recent data released by the American Community Survey, which the U.S. Census Bureau conducted. That’s more than 5.7 million Texans.It’s likely that someone you know — and probably one you wouldn’t have guessed — doesn’t have health insurance. More [...]
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US Army: Brigadier general has died in AfghanistanGruntDoc Sat, 04 Feb 2012 19:46:34 -0000
Natural causes. FORT HOOD, Texas (AP) – A 49-year-old brigadier general who died Friday in Afghanistan of apparent natural causes is likely the highest-ranking military officer to die in that conflict, according to military records. via US Army: Brigadier general has died in Afghanistan. At 49. Wow. Condolences to his family. Related posts: Army [...]
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Worker Trapped Under Boeing 787 TiresGruntDoc Sat, 04 Feb 2012 19:44:19 -0000
EVERETT, Wash. – Officials say emergency crews have rescued a worker who was temporarily trapped beneath the tires of a Boeing 787 jetliner at an Everett, Wash., airfield. via Worker Trapped Under Boeing 787 Tires Is Rescued. Yikes. Best wishes. via Drudge. No related posts. Related posts brought to you by Yet Another Related [...]
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Pediatric Emergency Care - Most Popular ArticlesThe Not-so-Nice Spice: A Teenage Girl With Palpitations and Dry MouthShah, Amy M.; Calello, Diane P.; Quintero-Solivan, Juliette; Osterhoudt, Kevin C.No abstract available
A Case of Functional Asplenia and Pneumococcal Sepsis: ErratumNo abstract available
First-Onset Seizure After Use of 5-hour ENERGY: ErratumNo abstract available
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