scholarly journals Self-injury attendances in the accident and emergency department

2003 ◽  
Vol 183 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Judith Horrocks ◽  
Sally Price ◽  
Allan House ◽  
David Owens
Keyword(s):  
Clinical Importance ◽  
Epidemiological Data ◽  
Psychosocial Assessment ◽  
Self Injury ◽  
After Care ◽  
Accident And Emergency ◽  
History Of ◽  
Self Harm ◽  
Accident And Emergency Department

BackgroundSelf-injury is a neglected area of self-harm research and we know little about its epidemiology, hospital care and outcome.AimsTo provide epidemiological data on self-injury and compare hospital management of self-injury with that for self-poisoning.MethodData were collected on all self-harm attendances to the general hospitals in Leeds over an 18-month period.ResultsPeople attending hospital for self-injury or self-poisoning do not form mutually exclusive groups. There were higher proportions of self-injury episodes compared with self-poisoning, where a history of self-harm or contact with mental health services had been recorded. Fewer psychosocial assessments were carried out after episodes of self-injury compared with self-poisoning but, when they were, follow-up was recommended more often.ConclusionsThe clinical importance of self-injury is not mirrored by the level of psychosocial assessment and after-care provided.

Impacted urethral stone presenting as urinary retention in a child

2021 ◽  
Vol 14 (1) ◽  
pp. e235022
Author(s):  
Kelly Storm Hoffmann ◽  
Alok Godse
Keyword(s):  
Urinary Retention ◽  
Urethral Catheter ◽  
Calcium Oxalate Stone ◽  
Accident And Emergency ◽  
Urethral Catheterisation ◽  
History Of ◽  
Accident And Emergency Department ◽  
Urethral Stone ◽  
Definitive Management

A seven-year-old boy was referred to our Accident and Emergency department with a history of urinary retention secondary to urinary tract infection and an inability to pass a urethral catheter. He had been treated a month before for suspected pyelonephritis by the referring hospital. Attempts at urethral catheterisation failed, and he was taken to theatre for cystourethroscopy and catheter placement. At this time, an impacted urethral stone was discovered. Because it could not be dislodged, a suprapubic catheter was placed, and the child was brought back at a later date for definitive management. Investigations revealed a pure calcium oxalate stone that was secondary in origin. There has been no recurrence during a follow-up period of 6 months.This illustrates that while rare, urethral stones do occur in children and should be considered in children presenting with urinary retention, haematuria and/or abdominal pain.

scholarly journals Compliance with NICE guidelines in the management of self-harm

2010 ◽  
Vol 34 (9) ◽  
pp. 385-389 ◽  
Author(s):  
Diane Mullins ◽  
Siobhan MacHale ◽  
David Cotter
Keyword(s):  
Clinical Excellence ◽  
Psychosocial Assessment ◽  
Standards Of Care ◽  
Liaison Psychiatry ◽  
Single Male ◽  
Nice Guidelines ◽  
Accident And Emergency ◽  
Self Harm ◽  
Male Patients ◽  
Accident And Emergency Department

Aims and methodTo identify the provision of psychosocial assessments for all people attending an accident and emergency department in Ireland with a presentation indicative of self-harm over 12 months and to investigate whether the National Institute for Health and Clinical Excellence (NICE) guidelines for self-harm were met.ResultsA total of 834 attendances for self-harm were recorded. A psychosocial assessment was undertaken by a member of the liaison psychiatry team in 59% of attendances. Single male patients under 45 years of age represented 39% of those who did not receive a psychosocial assessment.Clinical implicationsSingle men under the age of 45 years represent a vulnerable group in which levels of psychosocial assessment need to be optimised in order to meet the NICE guidelines for standards of care.

scholarly journals Increasing psychosocial assessment by introducing a self-harm pathway

2006 ◽  
Vol 30 (5) ◽  
pp. 169-172 ◽  
Author(s):  
Peter Lepping ◽  
Barbara Woodworth ◽  
Lucy Roberts ◽  
Jim Turner
Keyword(s):  
Emergency Department ◽  
The Self ◽  
Psychosocial Assessment ◽  
Clinical Implications ◽  
Protocol Adherence ◽  
Steering Group ◽  
Accident And Emergency ◽  
Before And After ◽  
Self Harm ◽  
Accident And Emergency Department

Aims and MethodTo audit whether the introduction of a self-harm pathway and protocol increases the number of psychosocial assessments. All episodes of self-harm in a defined period during 2002 (n=335) and 2004 (n=390) were reviewed before and after the introduction of a self-harm pathway and protocol. Adherence to the protocol was also investigated.ResultsAfter the introduction of the self-harm pathway and protocol, the proportion of psychosocial assessments requested had risen from 57% (2002) to 85% (2004). The proportion of psychosocial assessments completed had risen from 47% to 70%. Over the 2 years, the overall number of self-harm presentations was reduced by 27%.Clinical ImplicationsThe introduction of a self-harm pathway and protocol through a self-harm steering group is feasible, was well accepted and increased the number of psychosocial assessments after self-harm. It may also contribute to a reduction in the number of overall presentations with self-harm to the accident and emergency department.

scholarly journals Protocol for the assessment of self-harm in young people: initial audit and training implications

2007 ◽  
Vol 31 (6) ◽  
pp. 224-226 ◽  
Author(s):  
Sarah Huline-Dickens ◽  
Tony Adiele
Keyword(s):  
Young People ◽  
Mental State ◽  
Psychosocial Assessment ◽  
Training Requirements ◽  
Junior Staff ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
State Examination ◽  
And Training

Aims and MethodsThis paper describes the development and initial audit of a protocol for the assessment of young people up to the age of 18 years who presented to the accident and emergency department (A&E) with self-harm. A key part of the project was education and training.ResultsRegular training of senior house officers (SHOs) in A&E may have contributed to an increase in young people being admitted to a bed for proper assessment (as per the protocol), but psychosocial assessments undertaken by SHOs in A&E were still only partial, and there was no apparent use of the mental state examination.Clinical ImplicationsChild and adolescent mental health services have an important role to play in liaising with local A&E departments in training of junior staff in psychosocial assessment and the use of the mental state examination. This is especially relevant in the light of the new training requirements of the foundation years.

Outcome of Deliberate Self-Poisoning

1994 ◽  
Vol 165 (6) ◽  
pp. 797-801 ◽  
Author(s):  
David Owens ◽  
Michael Dennis ◽  
Susan Read ◽  
Norah Davis
Keyword(s):  
Risk Factors ◽  
Predictive Power ◽  
Psychiatric Care ◽  
Demographic Variables ◽  
Psychiatric Admission ◽  
Accident And Emergency ◽  
Self Harm ◽  
Accident And Emergency Department ◽  
One Year

BackgroundOne of the most important outcomes following an episode of non-fatal deliberate self-poisoning is its repetition.MethodIn a prospective follow-up study the subjects were 992 people responsible for 1096 consecutive episodes of deliberate self-poisoning recorded at a teaching hospital accident and emergency department. Risk factors examined were socio–demographic variables, psychiatric and self-harm history, aspects of the self-poisoning episode, and appearance and behaviour at accident and emergency; the frequency of each was compared between those patients who repeated within one year (n= 116) and those who did not (n = 876).ResultsThose who repeated were more likely to have ingested more than one drug, to report a previous episode of self-poisoning, to be aged 25–54, and to have experienced previous psychiatric care or psychiatric admission. They were less likely to be in paid employment, or to have expressed a threat to another person or written a note. The best predictor – previous psychiatric contact – only had a positive predictive value of 21 % (95% confidence interval 16–25%).ConclusionsRisk factors for repetition of self-poisoning should be kept up-to-date despite modest predictive power. More attention might be paid to clinical rather than socio–demographic aspects of self-harm.

scholarly journals Left-Sided Bochdalek's Hernia in a Young Adult: A Case Report and Literature Review

2021 ◽  
Vol 07 (03) ◽  
pp. e124-e126
Author(s):  
Mark Portelli ◽  
Mark Bugeja ◽  
Charles Cini
Keyword(s):  
Computed Tomography ◽  
Young Adult ◽  
Rare Case ◽  
Surgical Repair ◽  
Bochdalek Hernia ◽  
Case Presentation ◽  
Atypical Case ◽  
Accident And Emergency ◽  
History Of ◽  
Accident And Emergency Department

Abstract Purpose Bochdalek's hernia is a type of congenital diaphragmatic hernia occurring secondary to a defect in the posterior attachment of diaphragm. This condition commonly presents with respiratory insufficiency in infants. To date, there are less than 100 cases of Bochdalek's hernia presenting in adults published in the literature. The mainstay treatment of Bochdalek's hernia involves reduction of hernial contents back into the peritoneal cavity with a tensionless graft repair closing the diaphragmatic defect. Case Presentation We present an atypical case of the Bochdalek hernia presenting in a previously healthy 16-year-old male who presented to the Accident and Emergency department with a 2-day history of dysphagia and loss of breath. The Bochdalek hernia was confirmed on computed tomography (CT) imaging and the patient underwent surgical repair with Gore-Tex mesh. Conclusion The report shows a rare case of the Bochdalek hernia in a young adult, successfully managed with a laparotomy.

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 Assessment of the Sexual Violence Situation in a Regional Hospital in Guatemala: The Need for a Multidisciplinary Clinic

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S105-S105
Author(s):  
Blanca Soto ◽  
Miriam Canet ◽  
Diego Erdmenger
Keyword(s):  
Sexual Violence ◽  
Physical Violence ◽  
Negative Impact ◽  
Epidemiological Data ◽  
Depth Analysis ◽  
Significant Negative Impact ◽  
Comprehensive Health ◽  
History Of ◽  
Hepatitis B Testing

Abstract Background Sexual violence is a global health problem, in terms of age and sex, showing a significant negative impact on health. Incidence in Guatemala is among the highest of the region reaching an average of 23 cases reported daily nationally per statistics from the Ministry of Health in 2015. Methods Retrospective analysis of the database of all sexual violence cases reported from a secondary -level national hospital in Guatemala from January 2005 to September 2015 (period A) and in-depth analysis on demographic and epidemiological data along with information of the follow-up of cases between January 2012 and September 2015 (period B) was performed. Results Period A: 500 cases; female (96%; 481/500). Assault occurred between 16–20 years (34%; 163/481) 11–15 years (22.25%; 107/481), and 21–30 years (22.04%; 106/481). From all reported male cases, 73.68% (14/19) occurred under 15 years. Period B: 154/217 (70.96%) cases included; female (95.45%; 147/154), mean age: 17.87 years. Assault occurred in public spaces (57.14%; 88/154) and victim’s home (29.87%; 46/154). Almost 13% of victims reported history of previous assault, 5.84% by the same aggressor. More than one aggressor participated in 36.37% of assaults. Physical violence was associated in 57.79% of cases. Most victims (92.76%; 141/152) consulted within 72 hours of the assault. HIV, VDRL, and Hepatitis B testing performed in 100, 52, and 33.77%, respectively, were negative. Follow-up visits at 3, 6, and 12 months after the aggression were attended by 20.78% (30/154), 1.95% (3/154), and 1.95% (3/154) of victims, respectively. Psychology support was completed only in 18.18% (28/154). Emergency contraception was provided when indicated; pregnancy as result of the aggression was reported in nine cases (5.84%). Conclusion The study shows that young women were the most vulnerable group for sexual violence. There is a lack of multidisciplinary approach and follow-up. Interventions on infectious diseases screening have to be optimized to reduce the risk of ETS transmission. This evidence supports the need for a specialized clinic to ensure access to comprehensive health services for victims. Disclosures All authors: No reported disclosures.

Ice skating injuries: a survey of cases seen in an Accident and Emergency department

1991 ◽  
Vol 77 (2) ◽  
pp. 71-74
Author(s):  
A. P. Newton
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Epidemiological Data ◽  
Ice Skating ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
Sporting Activities ◽  
Patterns Of Injury

AbstractParticipating in sporting activities has its risks as well as its benefits. A simple study is described which documents the patients presenting at a casualty department after injury at an ice rink. Epidemiological data, risk factors and patterns of injury are discussed.

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