scholarly journals Patients either contacting a general practice cooperative or accident and emergency department out of hours: a comparison

2006 ◽  
Vol 23 (9) ◽  
pp. 731-734 ◽  
Author(s):  
P Giesen
Keyword(s):  
Emergency Department ◽  
General Practice ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Accident And Emergency Department

'Inappropriate' attendance at an accident and emergency department by adults registered in local general practices: how is it related to their use of primary care?

2002 ◽  
Vol 7 (3) ◽  
pp. 160-165 ◽  
Author(s):  
Alison Martin ◽  
Christopher Martin ◽  
Peter B Martin ◽  
Peter AB Martin ◽  
Gill Green ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Conditional Logistic Regression ◽  
Service Utilisation ◽  
Out Of Hours ◽  
Care Services ◽  
Accident And Emergency ◽  
Health Centres ◽  
General Practices ◽  
Accident And Emergency Department

Objectives: To identify the relationship between 'inappropriate' attendance at an accident and emergency department (AED) by adults registered with local general practices and their use of primary care. Methods: A case-control study matched for age, sex, distance from the AED, social class and registered general practice and set in a single AED and two health centres in South Essex. The participants were a total of 452 patients over 15 years old from the two health centres classified as having attended the AED 'inappropriately' in 1997 as identified by a modified Sheffield process method, and 452 controls. The predictive variables were measures of utilisation in the year 1997, including number of contacts in primary care, referral and investigation costs. Measures of morbidity were collected as potential confounders. These included a recorded history of anxiety or depression in the year 1997, or being in receipt of repeat prescriptions in that year. Results: The rate of 'inappropriate' attendance was 16.8% {95% confidence interval (CI): 15.7-18.0}. All measures of utilisation and markers of anxiety and depression were significantly positively associated with 'inappropriate' attendance, but there was no association with markers of chronic morbidity. Only the number of general practitioner (GP) appointments ( P < 0.0001) and out-of-hours advice calls ( P < 0.0001) were independently correlated with 'inappropriate' attendance in a conditional logistic regression. 'Inappropriate' attendees had approximately twice as many GP appointments and 10 times as many out-of-hours telephone contacts with the GP. Conclusions: GP-registered, 'inappropriate' attendees at AEDs utilise primary care services more than matched controls; this pattern of service utilisation appears to be unrelated to chronic physical illness. Thus, simply providing new, directly accessible primary health care services may not significantly reduce AED use.

Use of an accident and emergency department observation ward in the management of head injury

1993 ◽  
Vol 80 (8) ◽  
pp. 1079-1079 ◽  
Author(s):  
A. F. T. Brown ◽  
G. J. Wilkes ◽  
C. T. Myers ◽  
R. E. Maclaren
Keyword(s):  
Emergency Department ◽  
Head Injury ◽  
Accident And Emergency ◽  
Accident And Emergency Department

Hand Infections: An Audit of 160 Infections Treated in an Accident and Emergency Department

1993 ◽  
Vol 18 (1) ◽  
pp. 115-118 ◽  
Author(s):  
J. STEVENSON ◽  
I. W. R. ANDERSON
Keyword(s):  
Emergency Department ◽  
Complete Resolution ◽  
Wound Care ◽  
Duration Of Treatment ◽  
Mean Delay ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
The Mean ◽  
Careful Assessment

160 consecutive hand infections presented to an Accident and Emergency department over a four-month period. All but one were treated solely on an out-patient basis. The mean delay to presentation was three days, the mean duration of treatment was six days. Follow-up to complete resolution was achieved in 89% of cases. No patients were treated with parenteral antibiotics. The need for careful assessment, early aggressive surgery, and meticulous attention to the principles of wound care by experienced clinicians is emphasized.

scholarly journals Radiological features of body packers: An experience from a regional accident and emergency department in close proximity to the Hong Kong International Airport

2018 ◽  
Vol 25 (4) ◽  
pp. 202-210
Author(s):  
Ho Kai Patrick Tsang ◽  
Cheuk Kei Kathy Wong ◽  
Oi Fung Wong ◽  
Wing Lun William Chan ◽  
Hing Man Ma ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hong Kong ◽  
Body Packing ◽  
Radiological Features ◽  
International Airport ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
Body Packers ◽  
Solid Form ◽  
Hong Kong International Airport

Background: Body packing is a frequently used method for drug trafficking. Local information about the clinical and radiological features of body packing is lacking. Objectives: To evaluate the radiological features of body packers presenting to a hospital near to the Hong Kong International Airport and to compare the radiological features of solid form versus liquid cocaine. Methods: This was a retrospective cohort study. Medical notes of 269 suspected body packers, presenting to the Accident and Emergency Department of North Lantau Hospital under the detention by the law enforcement personnel from 1st January 2015 to 28th February 2017, were reviewed. The radiological features of body packing were retrospectively evaluated. Results: Sixty-nine cases were confirmed body packers radiographically. Majority of them (81%, 56/69) were cocaine packers. Powder form cocaine (67%, 49/69) was the most popular drug packed, followed by liquid cocaine (15%, 10/69). There was a trend of increasing incidence of liquid cocaine packers. The classical ‘double condom’, ‘tic tac’ and ‘halo’ signs were present in 94%, 72.5% and 42% of cases with radiologically confirmed body packing respectively. The ‘rosette’ sign was only identified in 1 case. Three new radiological signs, the ‘bag of eggs’, ‘lucent triangle’ and ‘black crescent’ sign, were suggested to aid identification of drug packets. The classical ‘tic tac’ sign was absent in all liquid cocaine packing cases (p<0.05). The liquid cocaine packets appeared irregular with indistinct border in majority of cases (p<0.05). The solid form packets were mostly opaque to faeces while liquid cocaine had variable density (p<0.05). Most solid form packets had homogeneous content which was in contrast to the heterogeneous content in liquid cocaine (p<0.05). Conclusion: Failure in detecting drug body packing may result in medicolegal consequences. Emergency physicians need to be aware of subtle radiological signs of liquid cocaine packets in the plain abdominal radiography.

scholarly journals A Retrospective Review of Patients with Radiological Missed Fractures in an Emergency Department in Hong Kong

2003 ◽  
Vol 10 (4) ◽  
pp. 215-222 ◽  
Author(s):  
VCH Ng ◽  
FL Lau
Keyword(s):  
Emergency Department ◽  
Management Plan ◽  
Lower Limbs ◽  
X Rays ◽  
Accident And Emergency ◽  
Assessment And Treatment ◽  
Spinal Region ◽  
Accident And Emergency Department ◽  
Clinical Records ◽  
Christian Hospital

Aim To review the clinical spectrum and outcome of radiological missed fractures in the Accident and Emergency Department of United Christian Hospital (UCH) in 2002. Method In UCH, radiologists report all X-Rays taken in the Accident and Emergency Department (AED) within 48 hours. The study period was from 1st January 2002 to 31st December 2002. AED notes, relevant clinical records and all X-rays of patients with suspected missed fractures as reported by radiologists were reviewed for information on clinical features, treatments and outcomes. Results A total of 286 cases of missed fractures were found. Fourteen (4.9%) involved the skull and maxillofacial region, 83 (29.0%) involved the chest region, 53 (18.5%) involved the spinal region, 72 (25.2%) involved the upper limbs and 64 (22.4%) involved the lower limbs. Of these 286 cases, 137 (47.9%) were followed up in AED, 90 (31.5%) were referred to specialist clinics for further management, 26 (9.1%) required admission to hospital for further assessment and treatment, and 33 (11.5%) defaulted follow up. Furthermore, 87 (30.4%) of these 286 missed fractures required a change in management plan: 3 missed fractures required operative intervention (internal fixation) and 84 missed fractures required some form of external immobilisation. This group of patient did not lodge any complaint or claim. Conclusion A&E doctors missed quite a number of fractures that might result in significant morbidity. However, a reporting system by radiologists within 48 hours from discharge can pick up all these missed fractures, and may prevent complaints and litigations.

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