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Showing results for tags 'Emergency medicine'.
Found 373 results
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Content ArticleTo tackle the serious harms, up to and including death, associated with eating disorders it is crucial that more is done to identify them at the earliest stage possible so that the appropriate care and treatment can be provided. The aim of this guidance from the Royal College of Psychiatrists is to make preventable deaths due to eating disorders a thing of the past.
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Content ArticleSerious pathology as a cause of musculoskeletal (MSK) conditions is considered rare, but it needs to be managed either as an emergency or as urgent onward referral as directed by local pathways. This guidance supports primary and community care practitioners in recognising serious pathology which requires emergency or urgent referral to secondary care in a patient who present with new or worsening MSK symptoms.
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Content ArticleThis study in BMC Infectious Diseases aimed to determine whether there is an association between Covid-19 infection and acute appendicitis. The authors performed a single institution retrospective review of pre-procedure Covid-19 testing and indications for surgical intervention. They found a high prevalence of Covid-19 in both all testing and pre-procedure testing during the enrolment period and observed a high prevalence of acute appendicitis among patients identified to be Covid-positive during pre-procedure testing and without recognised symptoms of Covid-19.
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Content ArticleThis instalment of Royal College of Emergency Medicine (RCEM)’s Acute Insight Series summarises key issues in mental health emergency care and provides recommendations for policymakers, NHS England, Integrated Care Systems, and Trusts to enable patients to access emergency mental healthcare in a safe, efficient, and timely manner.
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Content ArticlePEOPLE FIRST is a CQC resource to help system leaders and service providers.
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Content ArticleVonda Vaden Bates is an alliance builder and leadership coach. For over 30 years Vonda has guided professionals to succeed on behalf of their organisations and careers. She helps people move from potential to action, set and reach goals, manage engaged teams, and communicate with influence. In 2013 Vonda decided to contribute her skills on behalf of safety in healthcare after researching how her husband, Yogiraj Charles Bates, died from one of the most common preventable causes of death, hospital-associated venous thromboembolism. Advocating for every person in the care system, Vonda brings a compassionate voice, strategic skills, and collaboration expertise to improve communication and safety in healthcare. The Patient Safety Movement share her story.
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Content ArticleThis report by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) examines the quality of care provided to patients aged 16 years and over who were admitted to hospital following an out-of-hospital cardiac arrest (OHCA). The report is based on the findings of a study that looked at the clinical care delivered to patients from the time of an OHCA to discharge from hospital or death. The review of the clinical pathway included the community and emergency service response, hospital admission and inpatient care (in particular cardiac and critical care services). Data were also collected to assess organisational aspects of care within acute hospitals.
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Content ArticleThis National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report reviews the quality of care of patients aged 16 and over who had a pulmonary embolism (PE), The study aimed to highlight areas where care could be improved in patients with a new diagnosis of acute PE. A retrospective case note and questionnaire review was undertaken in 526 patients aged 16 and over who had a PE, and who either presented to hospital or developed a PE whilst an inpatient for another condition. You can view and download the following documents: Full report Summary report Summary sheet Recommendation checklist Infographic Slide set Commissioners' guide Fishbone diagram Audit toolkit YouTube video: Know the Score
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Content ArticleThe NHS Confederation, NHS Providers, the Academy of Medical Royal Colleges, National Voices and the Richmond Group of Charities have penned a joint letter to the new Prime Minister warning that without urgent action on key priorities the NHS risks being trapped in a relentless cycle unable to meet rising patient need and demand. The five organisations, which together represent NHS leaders, clinicians and patients, are calling on the new government to take rapid action to address five key priorities in the short term. These priorities are: Workforce Social care Capital funding The impact of the cost of living crisis and inflation Strengthening the voice of people living with ill health in decision making.
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Content ArticleThe UK has fewer hospital beds than almost any other European comparator and we can ill afford any loss of hospital capacity. While Covid has undoubtedly worsened performance, crowding in emergency departments was a problem before the pandemic. There are frantic attempts to shore up battered and fragile rotas and rota coordinators are scratching their heads. Meanwhile there has been a steady increase in the number of staff off work with Long Covid. While many have been flexible and accommodating to try to maintain their services, there is increasing burnout and uncertainty as to when all this will end. The workforce needs to feel valued and supported, writes Adrian Boyle, a consultant in emergency medicine. There needs to be an acknowledgment that the system is broken.
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Content ArticleAs dentists hand back their NHS contracts in record numbers, GPs are seeing the impact on their workload and patients’ health, especially in “dental deserts,” reports Sally Howard in this BMJ article. Over one week this spring, 20 patients presented at GP Abbie Brooks’ York surgery with abscesses, dental pain, and broken teeth—demanding antibiotics and painkillers. Brooks could not prescribe because she was not indemnified to perform dental work. Many of these patients, Brooks says, were not registered with a dentist or able to find an NHS dentist, and had already been told to call 111. The NHS medical helpline had advised patients to visit emergency NHS dentists 50 miles away from Brooks’ surgery. “Vulnerable patients often can’t get to emergency dentist appointments in Bradford or Leeds for logistical or financial reasons,” she says, adding that a small proportion of patients became difficult when Brooks was unable to help. “One woman was really quite angry that I wouldn’t incise and drain her abscess,” she says. “It’s not acceptable for GPs to have to deal with this crisis not of our doing.”
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Content ArticleIt is 20 years since researchers discovered that patients admitted to hospitals on Saturdays or Sundays are more likely to die than those admitted Monday to Friday. The ‘weekend effect’ was assumed to be because fewer hospital specialists work at weekends, meaning care was less good. However, there was no evidence to support this assumption. This NIHR Alert is based on: This NIHR Alert is based on: Bion J, and others. Increasing specialist intensity at weekends to improve outcomes for patients undergoing emergency hospital admission: the HiSLAC two-phase mixed-methods study. Health Services and Delivery Research 2021;9:13.
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Content ArticleForeign body ingestions are common events among paediatric patients. Button battery ingestions are particularly dangerous. Although the incidence of button battery ingestions has not changed over the last 30 years, the rates of emergency department visits, major morbidity, and mortality have risen dramatically since the introduction of the 3-volt–20 mm lithium batteries in 2006. These batteries are larger and more powerful than their predecessors, which has increased the incidence of esophageal impaction and significant tissue injury. The overall incidence of major morbidity or mortality after button battery ingestion is 0.42%. However, in children under six years old who ingest batteries >20 mm, the rates of major complications are as high as 12.6%. All reported fatalities have occurred in children under five years old. This article in the Anesthesia Patient Safety Foundation newsletter looks at the perioperative management of children who have ingested a button battery.
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Content ArticleThis video examines the crisis facing NHS ambulance services in the UK and looks at the impact of delays and lack of capacity on patient safety. Paul Brand, UK Editor at ITV News, speaks to ambulance crews, patients and a recently bereaved family about their experiences, and highlights the increased stress levels ambulance staff are reporting. Note: The video contains footage of a 999 call that some viewers might find distressing.
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Content ArticleIn this chapter, from the book 'Resilient Health Care, Volume 2: The Resilience of Everyday Clinical Work', Sujan et al. explore tensions and dynamic trade-offs through an example from our research on the safety of handover across care boundaries in emergency care. The authors describe the case study and then discuss the key theoretical concepts and their relationship to Resilience Engineering. It concludes the chapter with implications for research and for practice.
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Content ArticleMoral injury is a specific kind of trauma that can happen when when people face situations that deeply violate their conscience or threaten their core values. This blog for Scientific American looks at the experience of ER doctor Torree McGowan when the Delta wave of Covid-19 hit the central Oregon region where she works. It examines the impact that moral injury has had on her mental health and her relationship with patients. The author looks at how Covid-19 hugely increased the incidence of moral injury as people in frontline roles faced ethically wrenching dilemmas every day. The growing realisation that moral injury is a separate diagnosis to other conditions such as PTSD and depression is resulting in a wider range of treatments and trauma therapies. Many of these treatments encourage people to face moral conflicts head-on rather than blotting them out or explaining them away, and they emphasize the importance of community support in long-term recovery.
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Content ArticleThe Royal College of Emergency Medicine’s Safety Resources hub has information and resources about alerts, safety resources, safety in the Emergency Department and safety events. This page is managed by the Safer Care Committee, which is part of the Quality in Emergency Care Committee (QECC). The QECC has produced a series of strategy documents, explaining the role of RCEM, and these committees, in improving patient care.
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Content ArticleThis article in the BMJ highlights a number of recent articles that reflect on the realities facing the health service after the first brutal years of the Covid-19 pandemic. It summarises and links to articles in the BMJ about the elective care backlog, A&E waiting times, remote appointments, Government pressures that stop senior clinicians speaking out about pressures, and the need for credible policy solutions. It also highlights an article outlining how Brexit and the Northern Ireland Protocol have resulted in the UK being denied access to European research funding and meetings.
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Content ArticleWith emergency departments beyond capacity throughout the country, some hospitals have been trialling an approach of moving a set number of patients into inpatient wards each hour, regardless of bed availability. Is this a viable solution to the problems faced throughout the system? Dr Louella Vaughan assesses the evidence and argues for further caution before rolling out such a model.
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Content ArticleAmbulance services in England are under immense pressure. In July 2022, all ambulance services in England declared REAP (Resource Escalation Action Plan) level four, reflecting potential service failure. Volumes of calls to 999 are increasing, patients in distress and pain are waiting longer for help to reach them, and ambulance teams feel unable to do their job well. The new Secretary of State for Health and Social Care has previously named cutting ambulance waits as his number one priority. As he takes up the role for the second time, he will again need to include ambulances in his list of priorities for the health and care system. Steps taken to date to help address the underlying issues have not yet had an impact on the pressures facing ambulance services. This analysis from The Health Foundation looks at ambulance service performance and explores the contributing factors and priorities for improvement.
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Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) explores issues around patient handover to emergency care. Patients who wait in ambulances at an emergency department are at potential risk of coming to harm due to deterioration or not being able to access timely and appropriate treatment. This is the second interim bulletin published as part of this investigation, and findings so far emphasise that an effective response should consider the interactions of the whole system: an end-to-end approach that does not just focus on one area of healthcare and prioritises patient safety. The reference event in this investigation involves a patient who was found unconscious at home and taken to hospital by ambulance. They were then held in the ambulance at the emergency department for 3 hours and 20 minutes and during this time their condition did not improve. The patient was taken directly to the intensive care unit where they remained for nine days before being transferred to a specialist centre for further treatment.
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Content ArticleLucy is a world-leading authority on recovering from disaster. She has been at the centre of the most seismic events of the last few decades, advising on everything from the 2004 Boxing Day tsunami to the 7/7 bombings, the Christchurch earthquake in New Zealand, the Grenfell fire and the Covid-19 pandemic. In every catastrophe, Lucy is there to pick up the pieces and prepare for the next one. She holds governments to account, helps communities rally together, returns personal possessions to families, and holds the hands of the survivors. In her moving memoir she reveals what happens in the aftermath and explores how we pick up and rebuild with strength and perseverance. She takes us behind the police tape to scenes of destruction and chaos, introducing us to victims and their families, but also to the government briefing rooms and bunkers, where confusion and stale biscuits can reign supreme. Telling her own personal story, Lucy looks back at a life spent on the edges of disaster, from a Liverpudlian childhood steeped in the Hillsborough tragedy to the many losses and loves of her career.
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Content ArticleThe Healthcare Safety Investigation Branch's (HSIB's) local investigation pilot aimed to evaluate the organisation's ability to carry out effective locality-based patient safety investigations with actions aimed at specific NHS organisations, while still identifying and sharing relevant national learning. It differs from HSIB's usual national investigations, which make safety recommendations to organisations that can make changes at a national level across the NHS in England. The pilot published three investigations focused on cross boundary and multi-agency safety events: Investigation 1: incorrect patient identification Investigation 2: incorrect patient details on handover Investigation 3: transfer of a patient with a stroke to emergency care The report summarises how the HSIB local investigation pilot was undertaken, and shares findings applicable to local healthcare systems including healthcare organisations and Integrated Care Systems.
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Content Article
AvMA case study: Chloe's story
Patient-Safety-Learning posted an article in Risk management and legal issues
This article tells the story of two-year-old Chloe, who died after hospital staff failed to recognise that she had meningitis, sending her home after her parents first took her to A&E. The NHS Trust carried out an internal investigation which identified many areas where care should have been better and set out a range of recommendations for improving care of children in A&E in the future. The Trust only apologised to the family after an out-of-court settlement was made. -
Content ArticleThese resource lists compiled by US insurance company MedPro Group, highlight a number of expert and evidence-based sources that can be used to increase awareness of safety issues, identify areas of risk and determine mitigation strategies. They cover a wide range of healthcare safety topics: Advanced practice providers Anaesthesia and surgery Artificial Intelligence Bed safety and entrapment in senior care Behavioural health Behavioural health in senior care Burnout in healthcare Culture of safety Cybersecurity Disclosure of unanticipated outcomes Disruptive behaviour Elder abuse Electronic Health Records Emergency medical Treatment and Labour Act Emergency preparedness and response Emergency preparedness and response in senior care organisations Ergonomics and safe patient handling Falls and fall risk in older adults Handoffs and care transitions Health equity and social determinants of health Health literacy and cultural competence Healthcare-associated infections Healthcare compliance HIPAA Human trafficking and trauma-informed care Infection prevention and control in ambulatory care settings Infection prevention and control in dentistry Infection prevention and control in senior care organisations Informed consent LGBT+-inclusive care Maternal morbidity and mortality Medical marijuana Medication safety during care transitions Obstetrics and gynaecology Opioid prescribing and pain management Patient engagement Pressure injuries in older adults Sepsis Social media in healthcare Staff shortages and workforce issues Suicide screening in primary care Telehealth/telemedicine Violence prevention in home healthcare Violence prevention in the Emergency Department Wrong-site procedures
