A case is reported of deliberate release of CS gas (O-chlorobenzylidene malononitrile) in an enclosed space and the consequences for an accident and emergency department.
SUMMARYThe adequate management of severe pain in accident and emergency departments depends on knowledge of the pharmacology of analgesic drugs. To evaluate such a knowledge a study by questionnaire was conducted.Fourteen accident and emergency departments participated and one hundred senior house officers answered the questionnaire. A large percentage of the respondents would use an inappropriate route of administration (intramuscular 50% rather than intravenous 50%), some would use an inappropriate drug and often wait too long (90 min) before giving a further dose of analgesic should the patient continue to be in severe pain after the initial dose.These results suggest that (a) there is need for further teaching on pain relief at medical schools, (b) casualty officers need to be taught about analgesia when they start working in accident and emergency departments, and (c) it may be beneficial for accident and emergency departments to have an analgesic policy.
Objectives-The aim of this study was to determine the incidence, type, outcome, and possible risk factors of diving accidents in each year of a five year period presenting from one dive centre to a large teaching hospital accident and emergency (A&E) department. Methods-All patients included in this study presented to the A&E department at a local teaching hospital in close proximity to the largest inland diving centre in the UK. Our
SUMMARYTo determine why patients reattend an A&E department we surveyed 235 patients who returned unscheduled in a one-month period.Sixty-two per cent returned because of persistent symptoms. Sixty-three per cent presented within a week of their initial visit. Only 32% had attempted to see their GP. Thirty-five per cent of all patients claimed that A&E staff had advized them to return if they had problems. Half of the patients did not require treatment and 61% were discharged home. Twenty-one patients had pathology that had been missed on their first visit. Better patient education may minimize misuse of the service allowing better care for those who need it.
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