Publications by authors named "K Hartington"
Background And Aim: Following the coming into force of the International Labour Organisation Maritime Labour Convention (ILO/MLC) and International Maritime Organisation Standards for Training, Certification and Watchkeeping, Manila 2010 (IMO/STCW) amendments, the objective of this article is to provide the shipping community with an initial assessment of the economic reasons and business case, in support of both publicly financed and private telemedicine being implemented on board commercial vessels.
Materials And Methods: It provides the global scale of the requirement, the number of Telemedicine Assistance Services (TMAS) calls handled by participating TMAS, the average direct and indirect costs incurred by both TMAS and ship operators, responding to medical emergencies, and also provides a calculation of the market size of about 760 million Euro/year. It estimates a return on investment per ship, of implementing telemedicine on board to meet the MLC and STCW requirements at less than 1 year.
Objectives: The study proposed a clinical decision rule: In patients who have taken a deliberate overdose, but deny taking paracetamol or paracetamol containing compounds, who have a GCS of 15, understand English well, and have not taken excessive alcohol, there is no need to take blood for paracetamol estimation.
Methods: 307 consecutive emergency department patients were followed up, and the history of their overdose was correlated to blood paracetamol concentrations. In addition, clinicians were asked what level of confidence they required from such a clinical decision rule before they would use it.