1,856 research outputs found
The National Triage Scale
No full textBaron Dominique Jean Larrey, Napoleon's Surgeon in Chief is widely considered responsible for the introduction of concepts of triage. His Ambulance Volante began the process of removing large numbers of potentially salvageable patients from the battlefield and presenting them to surgical services. Thus there arrived at medical care large numbers of potentially salvageable patients who required sorting on principles of equity and efficiency “else much confusion would have ensued, had I not observed the order of dressing and arrangement observed by me in all battles.”\ud
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Emergency departments often experience similar patterns of patients to the battlefield with large numbers of undifferentiated patients presenting often in large numbers and requiring sorting on principles of equity and efficiency..
CPR in Australia: A case for national action
No full textPerhaps no single area of the emergency medical system has received such attention in the international literature as out-of-hospital cardiac arrest.\ud
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These studies concern sudden unexpected death in which an attempt at resuscitation is made, and exclude patients in whom death is expected or in whom attempts at resuscitation would be futile.\ud
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Out-of-hospital cardiac arrest will occur in an estimated one individual per 2,000 population per annum. That is 9,000 incidents per year throughout Australia. Further, particular focus has been on those cases of primary cardiac origin in whom known counter measures are more likely to be effective..
Emergency medicine: The next five years
No full textI had plenty of warning about the task of writing this, my first Editorial. Perhaps it says something of the personality of emergency physicians that we thrive on the challenge of deadlines. A quick search of the brain for that pithy saying, that attention grabbing first line that seizes the reader and shakes an earnest five minutes from a full agenda. Beginning a new venture is difficult for all of us. Particularly when the precedent has been set at such a high standard..
A Relational Theory of Authorship
No full textOver the years we have heard the debate as to whether authorship emanates solely from the individual or from the cultural context in which they inhabit. Writers such as Professors Woodmansee, Jaszi and Cohen have asserted a cultural theory of authorship. On one hand, there is the liberal philosophy of autonomous creativity evidenced in the notion of a "romantic author" (after the period known as romanticism). On the other hand we have more of a communitarian notion – that the author acts in a cultural context and authorship to some extent must be linked back to the social existence within which the author is situated.\ud
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This article argues that for too long we have privileged the notion of the romantic author so much so that it is hard to argue for any other approach to copyright than one that focuses primarily on the author and their assignees such as publishers or associated commercialising agents such as recording companies. Furthermore it suggests that this approach fits awkwardly with the burgeoning networked society fuelled by the Internet to the point where it threatens innovation and the potential for productivity. To this end the article argues that we should more explicitly acknowledge the contribution of culture to authorship and more so the role of each and every individual in assisting and nurturing that authorship, as well as the contribution of users to creativity through consumptive, productive and transformative use of copyright works
Prehospital fluid resuscitation: Conventional wisdom or inadequate science?
No full textAfter 25 years, the medical community remains unconvinced that prehospital fluid resuscitation in traumatised patients improves survival. Despite this lack of conviction, fluid resuscitation has been introduced in almost every Emergency Medical System (EMS) throughout the world and few would be prepared to suggest its removal.</p></div><div class="para"><p>Is there a logic behind this dichotomy or is it a case of conventional wisdom having no basis in science?</p></div><div class="para"><p>The aim of this paper is to identify and explore the essential questions which underlie the logic of current practice in an attempt to guide future conventions.</p></div><div class="para"><p>There are three questions which need to be addressed:</p></div><div class="para"><ul id="l1" class="custom"><li><span class="bullet">1</span><div class="text">What is the right focus for scientific evaluation?</div></li><li><span class="bullet">2</span><div class="text">Is current clinical practice appropriate?</div></li><li><span class="bullet">3</span><div class="text">Do the risks and complications outweigh any potential benefit?</div></li></ul></div><div class="para"><p>Fluid resuscitation is potentially life-saving when performed in the right manner, on the right patient, at the right time. The focus must be changed from technical issues to the knowledge and judgement required to deliver therapy appropriate to the needs of the particular patient
Psychosocial dimensions of medicine
No full textThis book begins by introducing us to patients in two general-practice waiting rooms. In an Australian general practice seven patients are waiting to see doctors. In a New Zealand general-practice waiting room are two patients. The healthcare needs of each patient are outlined. Of these patients and their circumstances, the editors and specialist chapter-authors ask a series of questions. What is life like for each? How might social role, economic status, and quality of social support impact on their lived experience of illness and injury? To what extent might psychosocial variables impact on the biomedical outcome of each? How might biomedical problems impact on psychosocial variables? What might be the emotional experience of each, their perception of stress, likely resilience, and potential for achieving quality of life despite their current medical circumstances? What factors might change their emotional experience? What will influence their psychological coping? What might be the cultural and spiritual resources or needs of each? How might health practitioners and the health system more generally respond to their biopsychosocial, cultural, and spiritual needs? To what extent, and how, could presenting problems have been prevented? How can positive attitudes to health and living be promoted? To encourage health professionals to view a patient in his or her broad context, as a person, and as a person in a family, a cultural group, and in a society, with advantages to patient and clinician, Jennifer Fitzgerald and Gerard J Byrne have brought together experts in medicine, psychology, social work, pastoral theology, and social science. Following a section in which the conceptual foundations of a biopsychosocial approach to healthcare are outlined, chapters on individual differences and developmental processes, relationships, the social determinants of health, existential and ethical issues, and prevention and promotion are offered. In each chapter, to illustrate and personalise key points, authors refer to the patients in the waiting rooms
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