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Showing results for tags 'Emergency medicine'.
Found 373 results
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Content ArticleThis article in the journal Patient Safety describes a state-wide, population-based study into tracheostomy- and laryngectomy-related airway safety events. The Pennsylvania-based study aimed to assess the relationship of these events with associated factors, interventions and outcomes, to identify potential areas for improvement. The authors queried the Pennsylvania Patient Safety Reporting System (PA-PSRS) to find tracheostomy- and laryngectomy-related airway safety event reports involving adults age 18 years and older that occurred between 1 January 2018, and 31 December 2020.
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Content ArticleThe article in the Journal of Global Health examines the unique patient safety risks that can arise in fragile, conflict-affected and vulnerable settings (FCV), including humanitarian crises, conflict, extreme adversity, services disruption and immediate or protracted emergencies. Recent estimates suggest a large proportion of the total number of preventable deaths take place in FCV settings, including 60% of preventable maternal deaths, 53% of deaths in children under five years, and 45% of neonatal deaths. The authors highlight a gap in knowledge and research about healthcare in FCV settings, which prevents researchers from being able to effectively assess interventions for quality, safety and sustainability. They suggest that more academic research is urgently needed in order to make policy and practice more effective in improving patient safety in these settings.
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Content ArticleDr Katherine Henderson is a senior A&E consultant in London and the president of the Royal College of Emergency Medicine. In this article for The Guardian, she describes the deep crisis facing urgent and emergency care in the UK. She describes hospital warnings of dangerous delays that have seen vulnerable patients waiting hours to be seen and admitted to hospital. This is dangerous, frustrating and undignified for patients, but also distressing for staff, who are finding themselves unable to offer the quality of care they want to deliver. Dr Henderson attributes the issues to shortfalls in healthcare staff and hospital beds, but also a lack of capacity in community care that is delaying patients being discharged from hospital. The situation is exacerbated by staff absence due to Covid-19. To tackle the crisis, she calls for clear plan to increase bed capacity and a robust, fully funded long-term workforce plan.
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Content ArticleHot debriefs are interactive, structured team conversations that take place immediately or very shortly after a clinical case. They are designed to help the whole team learn from the experience, reflect on what went well, identify team strengths or difficulties and to consider ways to improve future performance. In this blog, the authors describe how a multidisciplinary focus group at Edinburgh Emergency Medicine, alongside staff from the Scottish Centre for Simulation and Clinical Human Factors (SCSCHF), developed “STOP5: STOP for 5 Minutes”, a new tool to facilitate hot debriefs.
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Content ArticleDebriefing is a process of communication that takes place between a team following a clinical case. It identifies errors as well as areas of excellence for both teams and individuals. This article in BMJ Open Quality describes a quality improvement project in an emergency department in Ireland, which aimed to introduce hot debriefing following all cardiac arrests.
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Content Article
TAKE STOCK – Hot debrief tool (29 October 2019)
Patient-Safety-Learning posted an article in Emergency medicine
Debriefing after a patient death or serious incident is important for staff wellbeing, especially in the emergency medicine environment. While on placement in an emergency department, medical student Max Sugarman realised there was no debrief for staff or students involved in critical incidents. This led him to develop the TAKE STOCK hot debrief tool, which is an adaption of the STOP5 model created by Edinburgh EM and the Scottish Centre for Simulation and Clinical Human Factors. In this blog, Max talks about how critical incidents affect staff, how to make time for debriefs and how the TAKE STOCK tool works in practice. -
Content ArticleNHS Resolution has published a set of three reports which explore clinical issues that contribute to compensation claims within Emergency Departments.
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Content ArticlePutting patients in tents outside hospitals is a completely unacceptable ‘solution’ to the ambulance handover problems and the funding would be far better spent on staff in the community, says Royal College of Emergency Medicine president Katherine Henderson in this HSJ opinion piece.
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Content ArticleThis investigation by the Healthcare Safety Investigation Branch (HSIB) explores the timely recognition and treatment of suspected pulmonary embolism in emergency departments. Pulmonary embolisms can form when clots from the deep veins of the body, usually originating in the legs, travel through the venous system and become lodged in the lungs. A person suffering from a pulmonary embolism requires urgent treatment to reduce the chance of significant harm or death.
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Content Article“Hi, I’m the doctor. First I need to apologise for how long you’ve been waiting.” An apology is now the default way I introduce myself to patients in the busy emergency department where I work, writes an emergency medicine consultant in an article for the Independent newspaper. An apology for the shortage of beds, an apology for the shortage of staff and most importantly for the person in front of him, an apology for how long they’ve waited, in pain and distress, to be seen.
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Content ArticleThis report by the Healthcare Safety Investigation Branch (HSIB) has been published as part of a pilot launched to evaluate HSIB’s ability to carry out effective local investigations at specific hospitals and trusts, while still identifying and sharing relevant national learning. After an evaluation, it will be decided whether this model can be implemented more widely by HSIB. The investigation reviewed the case of a patient who had a stroke and was due to be taken to his local hospital emergency department (ED), but the ED advised paramedics this was not possible as their stroke service was closed. The alternative was to take him to a neighbouring hospital, but they also advised that they could also not take the patient. This was then referred back to the original ED, who restated their position, eventually leading to the neighbouring hospital agreeing to accept the patient. Once the patient arrived he then had to wait 40 minutes in an ambulance as the ED was very busy.
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Content Article
Pre-Hospital Care Podcast: Designing the RSI
Patient Safety Learning posted an article in Techniques
The Pre-Hospital Care Podcast is designed to have engaging and inspirational conversations with some of the World’s leading experts relating to pre-hospital care. This session interviews flight paramedic Paul Swinton, to talk about how to optimise the rapid sequence intubation (RSI) in the pre-hospital environment. It unpacks some of the nuances, challenges, and approaches that Paul has found from being both a pre-hospital practitioner and in innovating the layout and design for an RSI in creating the SCRAM bag. SCRAM™ (Structured CRitical Airway Management) is an innovative solution for enhancing the performance of emergency airway management. It involves the systemisation, standardisation, cognitive offloading, human factors and good governance are core principles to the design and philosophy of SCRAM. -
Content Article
Prevention of Future Deaths report – Chloe Lumb (17 February 2022)
Mark Hughes posted an article in Coroner reports
Chloe Lumb was known to have a genetic risk of aortic dissection that was being monitored. When she presented to James Cook University Hospital in Middlesbrough on 4 January 2021 a diagnosis of aortic dissection was not made, despite the prior knowledge about her risk and her clinical symptoms. The next day she contacted the hospital following discharge because of ongoing symptoms but was not asked to return to hospital. In her report, the Coroner states that a diagnosis of aortic dissection and appropriate surgical treatment would have prevented Ms Lumb’s death. -
Content ArticleThis article in the journal Resuscitation examines the needs of the 'forgotten patient' in out-of-hospital cardiac arrests (OHCA), which have a mortality rate of between 80 and 90%. Unlike many other critical illnesses, family members and partners often witness the collapse or have to perform CPR on their friend or loved one. The traumatic burden associated with these events can be significant, resulting in unique psychosocial needs both for survivors and those who witness or perform CPR. The partner or caregiver may struggle to deal with the fear, anxiety and guilt associated with the arrest, CPR provision and subsequent care upon discharge of their loved ones from hospital. This often makes the caregiver a ‘forgotten patient’ and there is growing literature examining the high levels of stress, anxiety, anger and confusion experienced by caregivers of survivors in the first 12 months after OHCA.
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Content ArticleOver the past 12 years, the number of emergency hospital admissions in England has increased by 42%, from 4.25 million in 2006/07 to 6.02 million in 2017/18. Over 60% of patients admitted to hospital as an emergency have one or more long-term health conditions such as asthma, diabetes or mental illness. Patients with long-term conditions spend under 1% of their time in contact with health professionals. The majority of their care, such as monitoring their symptoms and administering medication and treatment, comprises tasks they or their carers manage on a daily basis. To find out how able patients currently feel to manage their health conditions, the Health Foundation looked at Patient Activation Measure (PAM) scores, which assess four levels of knowledge, skill and confidence in self-management, for over 9,000 adults with long-term conditions. In this briefing, the Health Foundation assesses the evidence for the effectiveness of a range of approaches the NHS could use more often to support patients to manage their health conditions. These include: health coaching, self-management support through apps, social prescribing initiatives and peer support including via online communities.
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Content ArticleThe need to evacuate an intensive care unit (ICU) or operating theatre complex during a fire or other emergency is a rare event but one potentially fraught with difficulty: not only is there a risk that patients may come to significant harm but also that staff may be injured and unable to work. The Intensive Care Society and the Association of Anaesthetists have published new 2021 guidelines regarding fire safety and emergency evacuation of ICUs and operating theatres. These guidelines have been drawn up by a multi-professional group including frontline clinicians, healthcare fire experts, human factors experts, clinical psychologists and representatives from the National Fire Chiefs Council, Health and Safety Executive (HSE), NHS Improvement, Medicines and Healthcare Products Regulatory Authority (MHRA), and representatives from relevant industries.
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Content ArticleThis report by the Healthcare Safety Investigation Branch (HSIB) has been published as part of a local pilot, which has been launched to evaluate HSIB’s ability to carry out effective investigations occurring between specific hospitals and trusts. After an evaluation, it will be decided whether this model can be implemented more widely by HSIB. This investigation reviewed the case of a woman who was taken to an emergency department by ambulance in April 2021, following a 999 call from her Granddaughter to the emergency operations centre. The emergency operations centre used the wrong NHS number for the patient, which was assigned to her for the duration of her stay in hospital and led to her being offered incorrect medication.
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Content Article
Spotting the sick child - online learning tool (2020)
Patient-Safety-Learning posted an article in Paediatrics
This online interactive tool was commissioned by the Department of Health and Health Education England to support health professionals in assessing acutely sick children. It includes footage of real patients, guidance on assessing common symptoms and real test cases. -
Content ArticlePrehospital care is the care received by a patient from an emergency medical service before arriving at a hospital. This systematic review in the International Journal for Quality in Health and Care aimed to identify: how the prevalence and level of harm associated with patient safety incidents (PSIs) in prehospital care are assessed. the frequency of PSIs in prehospital care. the harm associated with PSIs in prehospital care.
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Content ArticleThis document outlines the Royal College of Emergency Medicine’s (RCEM) systemwide plan to improve patient care. The RCEM CARES campaign addresses pressing issues facing emergency departments (EDs) so that staff can deliver safe and timely care for patients. The campaign focuses on five key areas: Crowding, Access, Retention, Experience, and Safety.
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Content ArticleThis study from Harris et al. estimated the effect of prompt admission to critical care on mortality for deteriorating ward patients. They found that prompt admission to critical care leads to lower 90-day mortality for patients assessed and recommended to critical care.
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Content ArticleThis review by Healthcare Inspectorate Wales considers the impact of ambulance waits outside emergency departments on the overall experience of patients, which included their safety, care, privacy and dignity. It covers the period between 1 April 2020 and 31 March 2021, during the Covid-19 pandemic. The report highlights that although patients were positive about their experience with ambulance crews, handover delays are having a detrimental impact upon the ability of the healthcare system to provide responsive, safe, effective and dignified care to patients. It makes 20 recommendations for consideration by the Welsh Ambulance Services NHS Trust, health boards and the Welsh Government.
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Content ArticleEmergency Department *ED) crowding has potential detrimental consequences for both patient care and staff. Advancing disposition can reduce crowding. This may be achieved by using prediction models for admission. This systematic review from Brink et al. aims to present an overview of prediction models for admission at the ED. Furthermore, we aimed to identify the best prediction tool based on its performance, validation, calibration and clinical usability.
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Content ArticleGetting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings.
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Content Article
The House of Commons Science and Technology Committee and Health and Social Care Committee have published their Report following a joint inquiry, which began in October 2020, examining six key areas of the UK's response to COVID-19: the country's preparedness for a pandemic; the use of non-pharmaceutical interventions such as border controls, social distancing and lockdowns to control the pandemic; the use of test, trace and isolate strategies; the impact of the pandemic on social care; the impact of the pandemic on specific communities; and the procurement and roll-out of COVID-19 vaccines. The 150-page Report contains 38 recommendations to the Government and public bodies, and draws on evidence from over 50 witnesses as well as over 400 written submissions. The inquiry concluded that some initiatives were examples of global best practice but others represented mistakes. Both must be reflected on to ensure that lessons are applied to better inform future responses to emergencies.
