The rate of injury for each area of the body is within previously reported rates, with lower extremity injuries making up the largest category and leading to the majority of admissions. The most common time to sustain an injury was during landing, which represented a majority of both emergency room visits and hospitalizations.
Parents are less willing to accept the risk of radiation from CT scan on their child as the likelihood of positive findings decrease. Parents overwhelmingly want an informed discussion before getting a potentially dangerous test.
This project explored the differences between PDMP users and nonusers and outlined NP suggestions for process improvement. A better understanding of PDMP use will aid providers in safe prescribing while curbing the prescription drug epidemic and ultimately reducing abuse, misuse, and death from overdose.
Managing patients with deliberate self harm who refuse treatment in accident and emergency departmentsEducation and debate p 905
Advice and procedure require correctionEditor-In their lesson of the week on managing patients with deliberate self harm who refuse treatment in the accident and emergency department Hassan et al recommend that doctors must be fully conversant with the law on assessing capacity to consent to treatment and its application. 1 It is equally important in these difficult cases to be familiar with the application of the Mental Health Act 1983 or Mental Health (Scotland) Act 1984, which Hassan et al seem not to be. They state: "If the overdose is considered to be a consequence of a mental disorder then the patient can also be treated medically for the overdose under the terms of the Mental Health Act." This statement is reiterated in their proposed algorithm, recommended for use at accident and emergency departments. This is simply not the case.The Mental Health Act is for the treatment of mental disorders. It does not authorise the treatment of a physical disorder even if it arises as a consequence of a mental disorder. Therefore the Mental Health Act is of no help in the immediate medical management of patients presenting with deliberate self harm and refusing treatment, other than to permit detention in hospital if the patient is considered to be suicidal as a result of mental disorder.Treatment for the overdose will remain under common law based on assessment of competency to refuse treatment and the need to preserve life.The Mental Health Act states that treatment can be administered only if a patient is not capable of giving informed consent, provided that it is in the patient's best interest, is urgently necessary, and is in accordance with a practice accepted at the time by a responsible body of medical opinion skilled in the particular form of treatment in question. 2 A study by the MacArthur group found that only a minority of psychiatric patients had significant impairment in ability to provide valid informed consent for treatment. 3 The advice of Hassan et al and their algorithm require correction.
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