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Biomedical subjects

O J Warner

Publications and source records attributed to O J Warner.

4 recordsLinked to original sources
PubMed1998

Misuse of the London ambulance service: How much and why?

OBJECTIVES: To assess the degree of inappropriate use of the London Ambulance Service and analyse the reasons for misuse. DESIGN: An immediate assessment of the appropriateness of the "999" call by the ambulanceperson and casualty senior house officer followed by a retrospective review of each case by the accident and emergency (A&E) consultant. SETTING: A busy inner London A&E department. METHODS: Three hundred consecutive emergency ambulance arrivals to the A&E department underwent assessment as to the appropriateness of the call. RESULTS: Overall 53.7% of patients were considered justified in their call, 15.7% of calls were inappropriate, and in 19.0% of cases a unanimous decision was not reached. Eleven per cent of all forms were incompletely filled. CONCLUSIONS: Almost 16% of emergency ambulance calls were considered unanimously to be inappropriate. This suggests that 75,000 emergency calls per year to the London Ambulance Service are not necessary. The commonest reason for inappropriately calling an ambulance was that the caller felt that they had a serious or life threatening condition. The need for public education and deterrents of ambulance abuse are discussed. The further introduction of a nursing led triage "hot line" to appropriately dispatch ambulances according to clinical needs of the patient, and other alternatives to this are discussed.

Ambulances↗
PubMed1996

Magnetic resonance coronary artery imaging for redo coronary operations.

Imaging the native coronary vessels using contrast angiography can be difficult in the context of redo coronary operations when native disease is severe. When previous vein grafts undergo aneurysmal dilatation, imaging of the native vessel is restricted by the inability to infuse a sufficient volume of contrast medium through the graft and into the native vessel. We present a case of a patient whose redo coronary artery bypass graft operation was planned on the basis of magnetic resonance imaging of his native coronary arteries and vein graft after unsuccessful coronary angiography.

Coronary Aneurysm↗