Emergency and Urgent Care Services
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Item Emergency spinal MRI servies RWT quality improvement project.(The Royal Wolverhampton NHS Trust., 2025-04-05) Abou Hader, Khaled; Al Naseri, Ahmed; Dixit, Anurag; Mughal, Ejaz; Siddiqui, RaheelA retrospective audit of MRI scanning was undertaken at New Cross Hospital following the NHSE guidelines. The results are reported.Item 'Coughing up a tonsil' - oesophageal leiomyoma.(Oxford Academic., 2012-01-01) Molony, NWe report on a case of oesophageal leiomyoma presenting as a potential cause of sudden airway obstruction. The patient presented with a large mass in the oral cavity after an episode of forceful vomiting. The operative findings and histology of which confirmed this to be an oesophageal leiomyoma emanating from the upper oesophagus, a rare finding. The mass was excised and the patient’s subsequent post-operative recovery and follow-up has been unremarkable. This diagnosis should be borne in mind when one is referred the odd–sounding case of a patient who appears to have ‘coughed up their tonsil’.Item Use of phentolamine in the treatment of epipen induced digital ischaemia.(BMJ Journals, 2012-04-23) Holt, Alice; Xu, JingyuanA 33-year-old lady accidentally injected norepinephrine into her right thumb while cleaning the first aid box where a spare Epipen for her son was kept. She presented with pain, pallor and swelling to the distal phalanx of the right thumb. After a prompt literature search and discussing the case with the National Poisons Information Service, local injection of 0.15 ml (1.5 mg) of phentolamine in 1 ml of 2% lignocaine was advised. Peripheral perfusion was restored immediately after injection and fully recovery was noted at the review clinic the following day. The presentation of this case in the accident and emergency department prompted phone calls and literature search to define the most appropriate evidence-based management for this situation. The authors conclude that local infiltration of phentolamine is the treatment of choice and this highlighted the need for local treatment protocols.Item Rigid bronchoscopy: a consultant survey.(Royal college of surgeons of england, 2023-10-16) Amlani, A; Balbirsingh, V; Giblett, Neil; Mowat, A; Parekh, M; Sandhar, PIntroduction: Inhalation of foreign bodies represents a potentially fatal emergency in both adults and children. Chest x-ray, in isolation, is neither sensitive nor specific. Rigid bronchoscopy represents the gold standard to diagnose and retrieve paediatric foreign bodies. Cases are encountered infrequently, creating anxieties about their management. Little is known about the confidence in, and maintenance of, rigid bronchoscopy skills by ear, nose and throat teams. Methods: A 15-question survey was completed by 50 practising otolaryngology consultants in England. Results: Results show that almost 40% of otolaryngology consultants covering rigid bronchoscopy have not performed bronchoscopy in more than 5 years. Consultants raised concerns about the anaesthetic support and the speed of equipment assembly. Questions on clinical practice showed disparities in practice in the same scenario. Conclusions: The authors advocate addressing many of the issues raised by the study with a greater availability of simulation courses and regular scheduled intradepartmental teaching days for all professionals involved. National guidelines on criteria for transfer to tertiary centres would improve the consistency of practice.Item The RWT push model process.(The Royal Wolverhampton NHS Trust., 2023-04-25) Eve, Louise; Redding, Michelle; Wilmshurst, SarahImplementation of the RWT Push Model to improve the patient journey through the Emergency department, including ambulance handover time, length of stay in the Emergency Department and a reduction in the number of patients waiting more than 12 hours.