Propofol for procedural sedation in the emergency department.

Objectives: To observe procedural sedation practice within a district general hospital emergency department (ED) that uses propofol for procedural sedation.

Methods: Prospective observation of procedural sedation over an 11 month period. Patients over 16 years of age requiring procedural sedation and able to give informed consent were recruited.

The use of skull X-rays in head injury in the emergency department--a changing practice.

Introduction: This is a consequential study of a previous audit, evaluating the role of skull X-rays in the emergency department in patients with head injuries, to see if the changes recommended, (implementation of The Royal College of Surgeons of England guidelines) have been adopted successfully and had the desired result.

Patients & Methods: All patients who attended the accident and emergency department at the Royal Berkshire Hospital from 1-30 November 2003 with a diagnosis of head injury had their notes analysed for indications for skull X-ray, presence of fracture and outcome.

Results: 278 patients were identified as having a head injury and had notes available, 19% (54/278) of these patients had a skull X-ray, of whom 31% (17/54) had a clearly documented indication.