TY - JOUR T1 - Primary survey JF - Emergency Medicine Journal JO - Emerg Med J SP - 399 LP - 399 VL - 21 IS - 4 AU - Pete Driscoll AU - Jim Wardrope Y1 - 2004/07/01 UR - http://emj.bmj.com/content/21/4/399.abstract N2 - We do not like change, especially when the change is to a pattern of clinical care that has remained essentially the same for 20 years. In this issue we debate the recent guidelines issues by the UK National Institute for Clinical Excellence (NICE). We also publish a series of articles that explain the changes but also examine the practical implications. Leaman makes a number of points voiced by a number of emergency medicine clinicians and managers. Many hospitals will be struggling with the operational and financial impact of implementation. Swann points out some of the clinical weaknesses of the guidelines.
 See pages 400, 401 However, these guidelines represent a step … ER -