Busy District General Hospital Research Articles

Self poisoning: could psychiatric management be improved?

A retrospective case note study was made of 93 cases of deliberate self-poisoning admitted to the Casualty Department of a busy District General Hospital. The population under investigation is described in terms of age, sex and substance overdosed; it is broadly similar to populations described in most other studies of overdose. Our results show a higher incidence of functional psychoses (19.4%) than other studies, due to an excess of depressive psychosis in females. The main finding is that 84% of patients referred for psychiatric out-patient treatment either failed to attend or failed to complete the treatment. These results are discussed and suggestions made.

Effect of a surgical day unit on waiting lists

The effect of a surgical day unit (SDU) on the waiting lists of a busy district general hospital is reported over a 4-year period. During this time, 18 (15%) of the general surgical beds were closed for financial reasons. A real saving rather than an apparent one is reported due to the work expansion in the SDU.

Bipolar fixation of fractures of the distal radius: preliminary results

Twenty-eight unstable distal fractures of the radius have been treated with pins incorporated into a forearm plaster. The wrist is maintained in a neutral position permitting early use of the hand. Secondary displacement has been decreased. It is a safe and effective method of treating unstable distal fractures of the radius suitable for regular use in a busy district general hospital without the need of expensive specialized equipment.

Is the emergency ambulance service abused?

Analysis of 1000 consecutive patients brought to the accident and emergency department of a busy district general hospital by ambulance after emergency "999" telephone calls showed that 51.7% of these journeys were unnecessary. Medical cases accounted for a greater percentage of necessary calls than did trauma and surgical cases. Medical education of the public is essential if the number of these calls is to be cut.

CORONARY-CARE UNIT IN A DISTRICT GENERAL HOSPITAL

The results of the organisation, staffing, and running of a coronary-care unit (C.C.U.) in a district general hospital in the first year of its existence are presented. Of 300 cases admitted to the unit 246 were classified as emergency " routine " admissions. 149 of these had sustained an acute myocardial infarction, and the mortality-rate in this group was 18·8%. The results have been compared with those of other c.c.u.s and, in particular, those of the associated teaching hospital. It is concluded that the advantages of a C.C.U. can be combined with the service commitments of a busy district general hospital without any reduction in these commitments and without any increase in medical staff.