TY - JOUR T1 - Primary survey JF - Emergency Medicine Journal JO - Emerg Med J SP - 469 LP - 469 VL - 26 IS - 7 A2 - Maconochie, Ian Y1 - 2009/07/01 UR - http://emj.bmj.com/content/26/7/469.abstract N2 - This study, set in a medium sized district general hospital, found that for patients aged over 17 years with 2 or fewer diagnoses, the use of pathway bundles led to increased bed usage and improved length of stay when used from November 2006 to January 2007. The authors found that patients with acute coronary syndrome (ACS) and ST elevation myocardial infarction (STEMI) had reduced length of stay irrespective of their age and comorbidity. In individual disease-specific pathways, length of stay was reduced not only in ACS and STEMI but also sepsis, unlikely MI and upper GI bleed (in those with 2 or fewer diagnoses). Overall, in the group of patients with 2 or fewer diagnosis, up to 5.9 beds could be saved per day, an improvement by 2.5% (CI 0.25% to 4.38%) in medical bed usage. The authors intend to repeat the study to ensure that the effects are sustained and to assess the longer-term benefit. Worth watching out for! (see page 479)This practical and considered article looks at the top 10 steps in making sure that your ED is ready to deal with pandemic influenza. The article followed a visit by the UK authors to Hong Kong to learn about the experiences of ED and ITU colleagues in managing the … ER -