In this months JAEM there is a questionnaire study of post coital
contraception and the views of UK A&E departments.
Interestingly only 90 of 355 responding departments see more than 50,000,
with a quarter seeing less than 10,000 pts/p.a In the discussion the
authors say they give a more representative result than a previous study
which only studied 200 departments. they also state there is no consensus
but did not separate those departments that were consultant led (hopefully
these departments should be setting the standard). One could imagine a study
where all departments 200 departments out of 355 did some and it was put
forward that the other 155 should follow suit but it was these 155 who are
large consultant led departments practising evidence based emergency
medicine.
Personally I am not happy with studies that look at A&E departments
including all 560 departments under the same umbrella, whatever their size
or level of A&E specialist involvement. Should we not have a definition of
A&E department that separates out those units that do not have A&E
specialists working in them? You don't call a hospital a plastic surgery
centre just because they can treat a burn and a plastic consultant does a
clinic once a week.
So what should we call the large departments and what should we call the
small units?
Will we ever get a national agreement?
Dr Matthew Cooke
Senior Lecturer Accident and Emergency Medicine
Emergency Medicine Research Group (EMeRG),
Division of Primary Care, Public and Occupational Health,
University of Birmingham, UK.
> http://medweb.bham.ac.uk/gp/agp/pages/emerg.htm
and Walsgrave Hospitals NHS Trust, Coventry, UK.
Editor, Pre-hospital Immediate Care, BMJ Specialist Journals
www.prehospimmedicare.com
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