ABSTRACT
As the COVID-19 pandemic has spread across the globe, questions have arisen about the approach healthcare systems should adopt in order to optimally manage patient influx. With a focus on the impact of COVID-19 on the NHS, we describe the frontline experience of a severely affected hospital in close proximity to London. We highlight a protocol-driven approach, incorporating the use of CT in the rapid triage, assessment and cohorting of patients, in an environment where there was a lack of readily available, onsite RT-PCR testing facilities. Furthermore, the effects of the protocol on the effective streamlining of patient flow within the hospital are discussed, as are the resultant improvements in clinical management decisions within the acute care service. This model may help other healthcare systems in managing this pandemic whilst assessing their own needs and resources.
Subject(s)
Coronavirus Infections/diagnostic imaging , Lung/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Tomography, X-Ray Computed/methods , Triage/methods , Betacoronavirus , COVID-19 , Humans , Pandemics , SARS-CoV-2 , United KingdomABSTRACT
Many hospitals are still setting up acute stroke thrombolysis services, often delayed by fears over workload. However, there are few data on how many patients require urgent assessment before one is treated. We prospectively studied all referrals to the 24-hour stroke thrombolysis service, February 2009 - January 2010, in Southampton General Hospital. 128 patients were referred to the thrombolysis team and 20 received thrombolysis. The most common reasons for treatment exclusion were: stroke severity (37%), time from onset (26%) or CT findings (15%). Approximately six patients required urgent assessment by the thrombolysis team for every one treated. These data are crucial to inform service planning.
Subject(s)
Automobile Driving/standards , Health Knowledge, Attitudes, Practice , Health Status , Licensure , Physician's Role , Chi-Square Distribution , Documentation , England , Humans , Social ResponsibilitySubject(s)
Central Nervous System Bacterial Infections/complications , Nocardia Infections/complications , Opportunistic Infections/complications , Vidarabine/analogs & derivatives , Waldenstrom Macroglobulinemia/complications , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Central Nervous System Bacterial Infections/diagnosis , Humans , Male , Nocardia Infections/diagnosis , Opportunistic Infections/diagnosis , Tomography, X-Ray Computed , Vidarabine/therapeutic use , Waldenstrom Macroglobulinemia/drug therapyABSTRACT
Nocardiosis is caused by nocardia species, a Gram positive aerobic filamentous bacillus. It is ubiquitous in the environment and often presents as pulmonary disease in more than 70% of patients.1 Dissemination of the disease may manifest as brain abscesses, and is reported to account for approximately 2% of all brain abscesses.2,3 We present a case of cerebral nocardiosis in a patient with Waldenstrom's macroglobulinaemia, previously unreported in the literature.
