acute chest pain is an important and frequently occurring symptom in patients. chest pain is often a sign of ischemic heart disease. chest pain due to suspected acute coronary syndrome (acs) is responsible for a large and increasing number of hospital attendances and admissions. current practice for suspected acs involves troponin testing 10–12 hours after symptom onset to diagnose myocardial i...

McCartney is right, nagging doesn’t work: it assumes deliberate non-compliance, undermining patients’ autonomy and intelligence. Some people need nudges (as I do to complete the review that has been sitting on my desk for 10 days) and others support (as I do to clear more urgent work to find time for that review), but few respond well to being treated like an ignorant lazy person. Clinicians ne...

In many countries, family medicine (FM) training has been conducted mainly by senior family physicians alone. However, FM training in Singapore in the last 30 years has involved specialists working in close collaboration with family physicians. The areas in which specialists are currently involved include the training of FM trainees in tertiary hospitals, the Master of Medicine in Family Medici...

BACKGROUND Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD A review of patient data fro...

BACKGROUND Various studies have shown that stroke morbidity and mortality could be decreased if patients receive early diagnosis and treatment. Iranian Pre-hospital Stroke Scale (IPSS) is designed based on other prehospital stroke scales available across the world as well as experiences of emergency medicine specialists and pre-hospital emergency technicians to improve the diagnostic accuracy o...

OBJECTIVE Public health emergency planning includes a consideration of public health human resource requirements. We addressed the hypothetical question: How many public health physicians could Canada mobilize in the event of a public health emergency? METHODS We used the 2004 National Physician Survey (NPS) to estimate the number of public health physicians in Canada. Using weighting to acco...

STUDY OBJECTIVE Administration of tissue plasminogen activator (tPA) for acute ischemic stroke remains controversial in community practice. Well-organized hierarchic systems of acute stroke care have been proposed to link community hospitals to comprehensive stroke centers. We report safety and functional outcomes in patients treated with tPA in our regional emergency stroke network and compare...

OBJECTIVES To establish if emergency medicine and neuroscience specialist consultants have different risk tolerances for investigation of suspected spontaneous subarachnoid haemorrhage (SAH), and to establish if their risk-benefit appraisals concur with current guidelines. SETTING 4 major neuroscience centres in London. PARTICIPANTS 58 consultants in emergency medicine and neuroscience spec...

introduction: erythrocyte sedimentation rate (esr) remains as one of the most reliable tests in clinical practices. yet its use is time consuming and requires a large blood sample. the aim of this study was assessing a faster and reliable method of esr estimation. methods: an esr estimation method was described and performed on 108 patients using capillary tube (micro esr) and capillary periphe...

on the last wednesday of every year iranians celebrate the sanctity of fire in the annual festival of chaharshanbeh soori. each year many cases of firecracker-related injuries (fri) are reported during this festival. the aim of this study was to assess the pattern of injuries and the frequency of disabilities during this period. in 2011, a cross-sectional study was conducted at the emergency de...