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Biomedical subjects

P Burdett-Smith

Publications and source records attributed to P Burdett-Smith.

At least 19 recordsLinked to original sources
PubMed2002

A little nightclub medicine: the healthcare implications of clubbing.

OBJECTIVE: To describe the scale and range of acute medical problems among patients who present to an inner city accident and emergency (A&E) department after attending nightclubs in Liverpool. METHODS: From April 1997 to April 1998, all patients identified as having attended a nightclub before their arrival at the department were included in the study. Information regarding their attendance was gathered retrospectively using a standard proforma. SETTING: A large, city centre, teaching hospital A&E department with an annual new patient attendance rate of over 95,000. RESULT: 777 such patients were enrolled in the study (0.81% of all new attendances during the same period). This was probably an underestimate, as some eligible patients were not identified during the study. Predictably, most presentations were at the weekend between midnight and 08.00. Surprisingly, the commonest mode of transport to the hospital was an ambulance (38%, 298 of the total). Assault accounted for most presentations (57%, 443 of the total) and lacerations were the commonest injury (the face being most frequently affected). Alcohol was the commonest intoxicant overtly associated with the A&E department attendance. CONCLUSIONS: Injury after assault is the commonest precipitant of hospital care among clubbers in Liverpool. Alcohol is the most important contributory factor, although illegal drug misuse is a considerable challenge in the clubs themselves. A number of measures such as (a) the introduction of unbreakable glass or plastic containers; (b) the elimination of glass from outside clubs; (c) the provision of high quality immediate medical care at larger venues; (d) the curbing of over crowding and cheap drinks promotions; (e) registration of doormen, and (f) targeted policing of the areas around nightclubs are urgently required to reduce the healthcare (and civic) burden of clubbing. The cost for these should be borne by the highly profitable clubbing and brewing industries. A national code of practice for clubs-already in existence voluntarily-should be made mandatory.

Acute Disease↗
PubMed1999

Criminal injury compensation: from B to A.

Since its inception some 34 years ago the CICB has dealt with over 1000000 applications and paid out over 1.6 bn pounds sterling to victims of violence. The recent changes to the scheme and the formation of the CICA have streamlined the process and resulted in a slight reduction in average payments, but with more consistency in the amounts paid. There is no indication that the steady increase of around 5% per annum in the numbers of applications will fall and the service will continue to be in great demand.

Crime Victims↗
PubMed1997

Stun gun injury.

A case is presented of injury by a "stun gun." The different types of electric shock devices produced commercially are summarised and the potential injuries discussed.

Burns, Electric↗
PubMed1996

Tension pneumoperitoneum.

Tension pneumoperitoneum developing in a middle aged asthmatic male during resuscitation after a respiratory arrest is reported. This was associated with bilateral tension pneumothorax and caused severe respiratory embarrassment which was relieved by needle decompression, after decompression of the pneumothoraces. The chest is not the only body cavity that can contain air under tension.

Asthma↗
PubMed1996

Patients' understanding of tetanus immunisation.

OBJECTIVE: To investigate patients' understanding of the use of adsorbed tetanus toxoid (ATT) in an accident and emergency (A&E) unit. METHODS: 500 patients attending the minor injuries unit of the Royal Liverpool University Hospital in one calendar month completed a questionnaire under the supervision of the triage nurse. Analysis of results was at the 95% confidence level. Occupation was used as a guide to social class. RESULTS: Analysis of 296 male and 204 female respondents revealed that 50.4% thought that ATT is an antibiotic and 81% thought it protected against wound infection; 35.6% thought that concurrent antibiotic treatment would be rendered unnecessary. There was a significant gradient in accuracy of response from social classes I to V for each question. CONCLUSIONS: While few patients refuse the offer of ATT immunisation, true understanding of its purpose and limitations is lacking. This may reduce awareness of potential wound infection and possibly decrease compliance with concurrent antibiotic prescription. A&E and primary care staff should acknowledge the prevalence of these misunderstandings and assist in patient education.

Adult↗
PubMed1995

Improvements in trauma survival in Leeds.

One hundred and eighty-six cases of major trauma (Injury Severity Score > 15) admitted to the two Leeds hospitals in 1988/89 were compared with 198 cases admitted in 1992/93 to ascertain if a system of trauma care which had evolved in the hospitals during this time had affected outcome of these patients. Injury severity score, age, and sex distribution were similar for the two groups. There were significantly fewer deaths in 1992/93, particularly in those patients with a score less than 41. It would appear that the emphasis, since 1988, on timely and definitive management of patients with major trauma has led to improved survival of the seriously injured in Leeds.

Adolescent↗
PubMed1992

Estimating trauma centre workload.

To estimate the volume of major trauma seen in the UK in the light of the recent report from the Royal College of Surgeons of England, all publications relating to UK trauma practice published since the report were analysed. Major trauma represents one in every 1000 accident and emergency department attendances on average. Although this is less than in the USA, the severity of injury is at least equivalent to North American practice.

Humans↗