Out of hours care. Establish primary care centres in hospitals.
Explore the source record for details and available documents.
Emergency Service, Hospital↗
Biomedical subjects
D B Olney
Publications and source records attributed to D B Olney.
Multiple carpometacarpal dislocations.
We present a case of dislocations of the carpometacarpal joints without associated fractures. Although carpometacarpal injuries are relatively uncommon, it is rare for multiple carpometacarpal dislocations to occur without associated fractures. The injury is difficult to diagnose because of swelling of the hand. A lateral radiograph of the wrist has been found to be mandatory to its precise diagnosis if suspected. In the case presented here early diagnosis and closed manipulation in the accident and emergency (A&E) department resulted in a good outcome.
Adult↗
Applied hand anatomy: its importance in accident & emergency.
Hand injuries account for 10-20% of an Accident & Emergency department's workload. Early recognition of serious injury is vital to ensure appropriate management. This is only possible with a good working knowledge of hand anatomy. Forty consecutive A&E senior house officers (SHOs) were assessed on their knowledge of basic hand anatomy. The results are discussed as are the implications for undergraduate and post-graduate training.
Anatomy↗
Patterns of presentation of abused children to the accident and emergency department.
A search of accident and emergency department records showed that 61% of 85 children registered as being physically or sexually abused by the Department of Community Paediatrics at St James's University Hospital, Leeds, England, were found to have visited the accident and emergency department an average of 2.9 times before the diagnosis was made. Fifty-two per cent of the attendances were because of problems other than injuries. Staff of accident and emergency departments should be aware that abused children present with medical diagnoses as well as trauma. Increased awareness may result in earlier diagnosis of abuse in some of these children.
Child Abuse↗
The effect of head restraints and seat belts on the incidence of neck injury in car accidents.
During a 5-month period a study was made of motor vehicle occupants presenting at an Accident and Emergency department following an accident. Records were made of the incidence of neck injuries in relation to the presence of head restraints and the use of seat belts. There was a slight reduction in injuries when a head restraint was fitted but this difference did not achieve statistical significance. The incidence of neck injury was not increased if a seat belt was worn. It may be that the reason for the failure of head restraints to afford the expected protection is their inappropriate design and lack of adequate adjustability.
Accidents, Traffic↗
A review of the long term results of electric bar fire burns of the hand in children.
This paper reports on the long term problems of a group of patients who had sustained burns to the palmar aspect of one or both hands between eleven and eighteen years previously. Two of the eight patients who were re-examined had abnormalities of bony development in the hand. It is thought that the contracted scars resulting from the injury affect the growth of the bones of the hand. As development of contracted scars can develop at any time until growth of the hand is complete it is necessary to follow up these children until they reach maturity.
Burns↗
Objective verification of tetanus immune status in an apparently non-immune population.
Patients who are not known to be immunised to tetanus are considered to be non-immune. The appropriate treatment is the commencement of active immunisation with a course of three tetanus toxoid inoculations; if the wound is considered to be tetanus-prone, 250 IU of human anti-tetanus immunoglobulin is given concurrently. This study determined the true immune status of 166 patients who were considered to be non-immune on the basis of the available history. The majority (90 of 166) had protective levels of immunoglobulin (greater than 0.06 IU/ml) and further treatment was not indicated. Only two patients were non-immune. The remainder had protective levels (between 0.01 and 0.06 IU/ml) and required a tetanus toxoid booster.
Aged↗