Intravenous Drug Misusers Presenting to the Accident and Emergency Department of a Large Teaching Hospital a Failure of Clinical Management?

1989 ◽  
Vol 34 (2) ◽  
pp. 428-430 ◽  
Author(s):  
M.H. Stone ◽  
D.H. Stone ◽  
H.A.R. MacGreggor
Keyword(s):  
Emergency Department ◽  
Clinical Management ◽  
Hiv Transmission ◽  
Intravenous Drug ◽  
Drug Misuse ◽  
Royal Infirmary ◽  
Accident And Emergency ◽  
Large Teaching Hospital ◽  
Accident And Emergency Department

The records of all 77,686 attendances at or via the accident and emergency department of the Glasgow Royal Infirmary in 1986 were examined. Of these, 488 (0.6%) contained evidence of intravenous drug misuse (IDM). Most (68%) of the 354 attenders were male. The mean age of attenders in both sexes was 22 years. Over half of the presenting conditions were ‘surgical’ (mainly abscesses), while ‘psychiatric’ (including explicitly drug-related) conditions comprised about 30%. In almost two-thirds of cases, patients were discharged without specialist follow-up or care. Only 5% were referred for specialist assessment of their drug misuse. About a fifth were admitted. It is argued that these findings appear to represent a serious failure of clinical management requiring an urgent remedy, particularly in the light of the growing problem of HIV transmission in this group.

Psychiatric Service in 1967 at the Royal Infirmary of Edinburgh

1968 ◽  
Vol 13 (11) ◽  
pp. 388-393 ◽  
Author(s):  
R. C. B. Aitken ◽  
G. M. Carstairs
Keyword(s):  
Emergency Department ◽  
Teaching Hospital ◽  
Psychiatric Service ◽  
Royal Infirmary ◽  
Epidemiological Features ◽  
Accident And Emergency ◽  
Large Teaching Hospital ◽  
Treatment Centre ◽  
Accident And Emergency Department ◽  
General Wards

The psychiatric service provided at a large teaching hospital is reviewed. Epidemiological features are reported on the patients seen from 4 sources: poisoning treatment centre; general wards; psychiatric out-patient clinic; and accident and emergency department. Substantial increase in the referral rates from the first two sources is noted. Distributions of the diagnoses are given, with details of the further management offered.

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.

The Accident and Emergency Department Management of Deliberate Self-Poisoning

1988 ◽  
Vol 152 (6) ◽  
pp. 830-833 ◽  
Author(s):  
David W. Owens ◽  
Susan J. Jones
Keyword(s):  
Emergency Department ◽  
Psychiatric Morbidity ◽  
Patient Characteristics ◽  
Psychiatric Services ◽  
Case Register ◽  
Accident And Emergency ◽  
Emergency Department Management ◽  
Previous Contact ◽  
Accident And Emergency Department

Consecutive attenders (525) presenting at the Nottingham Accident and Emergency (A & E) department with deliberate self-poisoning were identified retrospectively. Their case-notes were examined for patient characteristics and clinical management. The Nottingham Psychiatric Case Register was examined for previous contact and use of psychiatric services over a 2-year follow-up period. Significant differences were found between those patients admitted to a ward and those who returned home from the A & E Department, in respect of likelihood of psychiatric morbidity and use of psychiatric services. One in three self-poisoning patients returns home directly from the accident department, and there seemed to be appropriate selection.

Motives and Intent: A Comparison of Views of Overdose Patients and Their Key Relatives/Friends

1986 ◽  
Vol 31 (7) ◽  
pp. 621-624 ◽  
Author(s):  
R. Varadaraj ◽  
J.D. Mendonca ◽  
P.M. Rauchenberg
Keyword(s):  
Emergency Department ◽  
General Hospital ◽  
District General Hospital ◽  
Suicidal Intent ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
Selection Of

The purpose of the study was to compare the perceptions of patients with those of key relatives or friends as regards motives for self-poisoning and intent to die, in ninety-eight overdose cases. Patients admitted to the accident and emergency department of a district general hospital in the county of Warwickshire, England, were interviewed following their recovery, Their key relatives/friends were also interviewed concerning their views of the emergency. Analysis of the responses of patients and key persons indicated that there was a significant association between the perceptions of the two classes of subjects as regards selection of escape/relief motives, warning prior to the attempt and intention to die. There was also a significant association between patient and relative perceptions of suicidal intent and relief at being alive. The implication of these findings as regards follow-up therapy is discussed.

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