Sports medicine and the accident and emergency medicine specialist

Background: Sport and exercise related injuries are responsible for about 5% of the workload in the accident and emergency (A&E) department, yet training in sports medicine is not a compulsory part of the curriculum for Higher Specialist Training.

Aim: To determine how A&E medicine consultants and specialist trainees view their role and skill requirements in relation to sports medicine.

Method: A modified Delphi study, consisting of two rounds of a postal questionnaire. Participants were invited to rate the importance of statements relating to the role and training of the A&E specialist in relation to sports injuries (six statements) and the need for knowledge and understanding of defined skills of importance in sports medicine (16 statements).

Value of research: This provides a consensus of opinion on issues in sport and exercise medicine that have educational implications for A&E specialists, and should be considered in the curriculum for Higher Specialist Training. There is also the potential for improving the health care provision of A&E departments, to the exercising and sporting population.

     

Recent advances in emergency life support

With additional international input, recent changes in emergency life support are reflected in updated guidelines for Advanced Cardiac Life Support (ACLS) from the American Heart Association and new technology in the arena of vascular access and emergency airway management. These changes will expand nurses' ability to provide advanced levels of care, even in the prehospital situation, and represent a more rigorous evidence-based approach than ever before. As early morbidity and mortality in emergency situations are frequently associated with complications associated with airway management and vascular access, recent development in these areas are reviewed along with evolution in ACLS guidelines.     

Basic pharmacology and advances in emergency medicine

To provide optimal pain control for their patients, emergency physicians should have an in-depth understanding of analgesic drugs and how to use and combine them effectively. The purpose of this article is to describe the pharmacology and use of analgesic agents that are most useful in the management of acute pain in the emergency department.     

The lateral soft tissue neck X-ray in accident and emergency medicine.

Five patients with upper aerodigestive tract pathology seen acutely in the Accident and Emergency department at St Mary's Hospital, London are presented. The value of the lateral soft tissue neck X-ray in their diagnosis is discussed.     

Reviews in accident and emergency medicine: the past and the future.

OBJECTIVE--To determine whether reviews published in the past 10 years are as helpful as they could be to their readers, and to explain why future reviews should meet certain methodological criteria. METHODS--The quality of 16 reviews published in two journals dealing with accident and emergency medicine over 10 years was objectively assessed using 11 currently recommended criteria. RESULTS--The median number of methodological criteria satisfied was two. Only five of the reviews posed a specific question or problem and then answered this with conclusions based on evidence presented. CONCLUSIONS--If reviews are to enhance patient care, the way in which they are performed, written and used must change.