ABSTRACT
What was the nature of the CPD activity and/or practice-related feedback and/or event or experience in your practice? The CPD article discussed acute pulmonary oedema, which is the build-up of excess fluid in the lungs. It is a life-threatening illness that should be treated as a medical emergency.
Subject(s)
Pulmonary Edema/diagnosis , Pulmonary Edema/therapy , Acute Disease , Certification , Humans , United KingdomABSTRACT
Following the 2005 London bombings, a novel public health program was instituted to address the mental health needs of survivors. In this article, the authors describe the rationale for the program, characteristics of individuals assessed within the program, and preliminary outcome data. In addition to validated screening instruments and routine service usage data, standardized questionnaire outcome measures were collected. Seventy-one percent of individuals screened positive for a mental disorder. Of those receiving a more detailed clinical assessment, PTSD was the predominant diagnosis. Preliminary outcome data on 82 patients revealed large effect sizes for treatment comparable to those previously obtained in randomized controlled trials. The program succeeded in its aim of generating many more referrals of affected individuals than came through normal referral channels.
Subject(s)
Cognitive Behavioral Therapy/methods , Health Promotion , Mass Screening/methods , Stress Disorders, Post-Traumatic , Terrorism/psychology , Adult , Catchment Area, Health , Diagnostic and Statistical Manual of Mental Disorders , England/epidemiology , Female , Humans , International Classification of Diseases , Male , Middle Aged , Severity of Illness Index , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/therapy , Surveys and QuestionnairesABSTRACT
Nebulized levalbuterol has been documented as more efficacious than albuterol in enhancing airflow in Emergency Department (ED) patients with bronchospasm. This work attempts to determine if nebulized levalbuterol yields similar improvements in peak flow measurements as those produced by albuterol in the Emergency Medical Services (EMS) arena. All adult EMS patients given a nebulized beta-agonist from January to June 2000 were included in this prospective, before-and-after, open-label study. Data collected included demographics, initial peak expiratory flow (PF), and use of home inhaled or nebulized bronchodilators before EMS arrival (PRE-TX). Outcome variable was the change in PF after a single EMS treatment with one of the study agents. Statistical analysis was performed using t-test and chi-square techniques; p was defined as 0.05. There were 298 patients enrolled; complete data for analysis were available for 196. Mean age was 68.0 years; 44.4% were male. Overall, albuterol produced a PF change of 19.7%; levalbuterol yielded a change of 20.4% (p = 0.9). In contrast to ED data, levalbuterol and albuterol produces similar changes in PF in the prehospital setting. Explanations for this finding may be linked to the pharmacokinetics of single vs. dual isomer preparations, and to the time frames of EMS care. Further efforts correlating EMS and ED data may better define the use of levalbuterol in prehospital care.
