SUMMARYA total of 300 patients attending an Accident and Emergency department with ophthalmic complaints needing topical antibiotic treatment were treated with fucithalmic or chloramphenicol (chloromycetin). Their compliance and the incidence of side effects were assessed.There was a 70.3% response rate to the questionnaire. Of the patients 51-3% using fucithalmic completed the 5 day course compared with 37*2% of those taking chloramphenicol. However, no patients were found to have suffered as a result of failing to complete the course. The incidence of side effects was similar in both groups.
Most accident departments face annually increasing workloads and many departments have medical staffing problems and inadequate numbers of nurses. This means less time for those patients who need us most. The definition of the inappropriate attender may be debatable and the level of abuse variable but most would agree that at least one, and perhaps two patients in five attending could easily be dealt with elsewhere. Most departments have adopted a policy of resignation to this situation,-after all, someone has to see them, and a community service is provided-but this care is given at the expense of poorly patients. A small number of departments have tougher criteria as to whether a patient is attended to or not-if the problem is over a day or two old, a patient will only be seen if they are referred by a general practitioner; but many serious problems take time to develop, and further damage may be caused by rigid rules inperceptively applied-and the importance of patients being able to obtain urgent second opinions has been recently illustrated (Jones & McGowan, 1989).This vexatious problem has been the subject of discussion (Editorial, Brit. J. Acc. Em. Med., 1986) for years. Increasing public perception as to the nature and urgency of their problems and a better undlerstanding as to where a particular difficulty can most reasonably be resolved should help (though such insights also expose our Health Service inadequacies). Some general practices and accident departments provide pamphlets indicating their facilities and range of responsibilities. Some attenders could be managed comfortably by a nurse practitioner, leaving doctors free to concentrate on more pressing problems; surely, however, the nurse practitioner would function best at the health centres seeing those very people who should not be attending our accident departments. It has also been suggested that the problem be accepted and a department formally provide a general practice service. This may work for some departments with particular circumstances (O'Driscoll et al., 1987) but is not the answer for most of us who lack both staff and space to handle such an invited increasing flow.Our Health Service is changing whether we like it or not. District managers struggling with limited budgets may turn their cold fiscal eyes on an accident department which sees all and sundry. General practitioners are expected to be more
and informed approach to long term catheterisation and are eager to support further research into specific aspects of catheter management. Two short booklets are available from Bard Limited for patients and those responsible for their care, and further information will be gladly given to any doctor heeding Mr Kinder's call.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.