Alcohol-impaired driving continues to be a leading cause of fatal crashes. The popularity of drinking at home, particularly in rural areas, has implications for police enforcement strategies and suggests that drink driving interventions that focus on community values and looking after friends might be beneficial. Importantly, the study highlights the need for a broader holistic approach to reduce the high levels of alcohol consumption and alcohol dependence underlying drink driving behavior.
• Analyses of injury data to understand the nature and extent of injuries to children on bikes as passengers and riders. • Child cyclist injuries as a significant safety issue within Victoria, Australia. • Young children aged 0-3 years experienced significantly more head injuries compared to older children.
time of diagnosis or very shortly afterwards. Two thirds of these (69.5%) were discharged on LMWH but the remainder (30.5%) were discharged on warfarin. Perhaps unsurprisingly, a similar percentage of the consultant physicians who completed the internet-based survey said they would prescribe LMWH, although a sizeable proportion continue to prescribe warfarin. Conclusion NICE guidance is largely being adhered to but a proportion of clinicians continue to prescribe warfarin despite there being good evidence that LMWH is associated with a reduced risk of VTE recurrence in this group. 2 Further investigation is needed to determine whether this pattern of prescribing is prevalent throughout the UK, and why the guidance is being ignored in our Trust. Hypothesis The risk of Venous Thromboembolism (VTE) including Pulmonary Embolism (PE) increases proportionately with the level of d-dimers. Introduction The risk of PE/VTE is low when the values of ddimers are below the reference range (1) (<500 ng/ml in our hospital). There is no clear evidence to suggest that risk of VTE increases proportionately with rising levels of d-dimers. We studied the correlation between the various values of d-dimers and the associated risk of having a PE/VTE. Methods Data was collected retrospectively from March 2011 to Feb 2012. For the study we divided the patients into 3 risk groups based on d-dimers. Group1: 500-1000; Group 2: 1000-5000; Group 3: >5000. Each group was analysed by separate individual. Data was collected by selecting only those patients who had definitive scan to investigate for PE/VTE Results See Suspected pulmonary embolism (PE) is a common reason for referral to the medical team on call. The pulmonary embolism rule-out criteria (PERC) is a validated scoring system to identify patients at low risk of PE, allowing for possible discharge from the Emergency Department (ED) prior to referral. It is potentially advantageous over the modified Well's score (MWS) for PE, as a D-dimer result is not required.We aimed to investigate two practice models: the PERC and the MWS in the investigation of suspected PE.Those patients referred to the medical team on call by the University Hospital Lewisham ED with a suspected PE were identified over a 3 month period (January to March 2012). Further information was gathered on each patient by review of their ED notes. Patients who did not meet all 8 PERC criteria or had a MWS >4 were considered to be at high risk for PE.94 patients were identified. The mean age was 53 years (range 18-92) and 68 were female (72%). 9 PEs were diagnosed.13/94 patients met all PERC criteria, among these no PEs were diagnosed. This group underwent 10 D-dimer tests (70% positive), 2 CTPAs, and 3 V/Q scans. The overall length of stay directly related to waiting for these tests was 6 days, with a mean admission length of 1.3 days per patient.When all PERC criteria were not met due to age (>50 years) alone, the D-dimer proved an excellent 'rule-out' test, as the 2 patients in this cohort with PEs, had strongly positive ...
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