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Kevin Mackway-Jones

Publications and source records attributed to Kevin Mackway-Jones.

31 records · Page 2Linked to original sources
PubMed2003

Predictors of outcome following brief psychodynamic-interpersonal therapy for deliberate self-poisoning.

BACKGROUND: We found that brief psychodynamic-interpersonal therapy was more helpful than usual care in deliberate self-poisoning patients, and resulted in reduced suicidal ideation and repetition of self-harm in the 6 months post-treatment. Here, we explore which baseline factors predicted outcome following treatment. METHOD: Patients presenting to an emergency department with deliberate self-poisoning were randomly assigned to brief psychodynamic-interpersonal therapy (PIT) or usual care. Severity of suicidal ideation 6 months post-treatment was used as the main outcome measure. Sociodemographic features and baseline psychological measures were used as predictor variables. Univariate and regression analyses were used to identify predictors of outcome for the whole group and for those who received psychotherapy. RESULTS: Principal predictors for the psychotherapy group were baseline severity of depression and a prior history of self-harm. For the group as a whole predictors were severity of suicidal ideation, anxiety and prior history of self-harm. CONCLUSIONS: Four session PIT for deliberate self-poisoning is effective in reducing suicidal ideation in patients with less severe depression, no prior history of self-harm, and who have not consumed alcohol with the overdose. Extended therapy may be indicated for those with more severe depression.

Adult↗
PubMed2003

Ascorbate for alkali burns to the eye.

A short cut review was carried out to establish whether ascobate drops are useful in the management of alkalis burns to the eyes. Altogether 33 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Adult↗
PubMed2003

Detecting high-risk patients with chest pain.

AIM: To assess the ability of nurses using the Manchester Triage System (MTS) to identify those patients with chest pain requiring immediate electrocardiogram (ECG) and physician assessment within ten minutes. METHOD: A four-week prospective cohort of all patients attending with chest pain compared detection of risk by nurses using the MTS to that of researchers using best available evidence-based prognostic indicators from history. RESULTS: The study of 167 patients showed that nurses using MTS had a sensitivity of 86.8 per cent (95 per cent confidence interval (CI), 78.4-92.3 per cent) and a specificity of 72.4 per cent (95 per cent CI, 61.4-81.2 per cent) when identifying high risk cardiac chest pain. CONCLUSION: Nurses using the MTS are a sensitive tool for identifying high risk cardiac chest pain but further work is required to assess whether additional training can improve sensitivity.

Angina Pectoris↗
PubMed2002

Systolic hypertension and the response to blunt trauma in infants and children.

OBJECTIVES: To describe age-related systolic blood pressures and pulse rates in children following blunt injury. To compare these variables with standard reference values for uninjured children at rest and with reference ranges from the Advanced Paediatric Life Support (APLS) guidelines. DESIGN: Secondary analysis of a prospective cohort. SETTING: Emergency departments throughout England and Wales. PARTICIPANTS: 12906 children presenting with acute blunt traumatic injury from August 1989 to September 1998. MAIN OUTCOME MEASURES: Systolic blood pressure and pulse rate on arrival. RESULTS: Injured children had higher systolic blood pressures than the standard quoted 'norms'. Standard reference values of systolic blood pressure for children at rest always appeared below the 50th percentile for our cohort of injured children (range 7th-27th percentiles). Pulse rates for children at rest were always towards the mid-range for injured children (range 41st-54th percentiles). These results appeared unrelated to injury severity. Age related APLS reference ranges for systolic blood pressure and pulse rate resembled the standard reference values for uninjured children at rest. CONCLUSIONS: Injured children have a relative systolic hypertension compared with children at rest. Pulse rates in the two groups are comparable. Following injury, children with apparently 'normal' age-specific systolic blood pressures on arrival in the Emergency Department are relatively hypotensive and should be carefully assessed.

Adolescent↗
PubMed2002

Planning for major burns incidents by implementing an accelerated Delphi technique.

OBJECTIVE: This paper presents a series of practical guides for use in planning and responding to a major incident involving large numbers of burns casualties. METHOD: The guidance is based on the findings of an expert Delphi study published as an accompanying paper. RESULTS: The guidance covers preparation and all aspects of the response from prehospital care and hospital care to resolution recovery. Emphasis is placed on the management of the secondary/tertiary care interface as this is the point at which significant difficulties may arise. The importance of local interpretation of guidelines is emphasised. CONCLUSION: This practical guide for emergency planners will improve the preparation and response to a major incident involving burns.

Burn Units↗
PubMed2002

Planning for major burns incidents in the UK using an accelerated Delphi technique.

BACKGROUND: Major incidents require careful planning if they are to be managed well. Although a generic plan to deal with all major incidents is essential, a number of "special incidents" deserve special consideration because of their potential to impact on specialist services. This paper examines the problems of managing a major incident involving large numbers of burns casualties. METHOD: A three-round Delphi study was conducted using a multidisciplinary panel of experts from prehospital care, emergency medicine, burns surgery, intensive care and emergency planning. RESULTS: A series of consensus statements on the management of burns incidents are presented. An accompanying paper describes the practical implementation of this guidance. CONCLUSION: Specific consideration should be given to the problems of managing a major incident involving burns casualties.

Burn Units↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. The use of antibiotics in venomous snake bite.

A short cut review was carried out to establish whether antibiotics reduce the incidence of infection after venomous snake bite. Altogether 60 papers were found using the reported search, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 3. A clinical bottom line is stated.

Adult↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Antibiotics in non-venomous snakebite.

A short cut review was carried out to establish whether prophylactic antibiotics reduced the incidence of infection after non-venemous snake bite. Altogether 60 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Adult↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. White cell count and diagnosing appendicitis in children.

A short cut review was carried out to establish whether a single white cell count has clinical utility in the diagnosis of acute appendicitis in children. Altogether 100 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Appendicitis↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. White cell count and diagnosing appendicitis in adults.

A short cut review was carried out to establish whether a single white cell count has clinical utility in the diagnosis of acute appendicitis in adults. Altogether 176 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Adult↗
PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Serum amylase or lipase to diagnose pancreatitis in patients presenting with abdominal pain.

A short cut review was carried out to establish whether serum amylase was better than serum lipase in the diagnosis of pancreatitis in patients presenting with abdominal pain. Altogether 320 papers were found using the reported search, of which seven presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Abdominal Pain↗