Ideas for an optimal workflow to generate a medication list include involving patients and utilising clerical staff to a greater extent in medication information gathering, identifying and flagging patients with missing medication information, and gathering only the medication information needed to make clinical decisions in the emergency department.
Aortic dissection: an x ray sign A 55-year-old man, with a history of hypertension and smoking, presented with severe acute onset central chest pain, radiating through to the back and down to the umbilicus area of the abdomen. His blood pressure was 210/110 in both arms, peripheral pulses were normal, and there was no focal neurological sign. An electrocardiogram was normal. Chest x ray did not show obvious mediastinal widening, but incidentally the space between intimal calcification and the outer border of the aortic arch was .1 cm, a recognised radiological sign of aortic dissection (fig 1). Awareness of this is crucial. Troponin was normal but D-dimer was raised. A computed tomography scan confirmed aortic dissection type B, managed conservatively with intravenous labetolol and analgesia, with a good outcome.
In the past, intra-hospital communication during disaster incidents relied heavily on pagers, phones or direct verbal communication. Other communication channels may include facsimile transmission, email and “walkie-talkie”. There was often delay or inadequacy of information dissemination. This article introduces the “News Board for Emergency Incidents” recently launched in our hospital intranet as an efficient communication channel to convey up-to-date information to other hospital staff during major incidents. The background and process of development of this new communication modality is discussed. We also try to explore possible future development of such “news board” via intranet broadcast.
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