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Emergency care below standard

HALF OF patients admitted to hospital in an emergency receive poor care, which doubles their risk of dying, an inquiry has revealed.

An investigation into the quality of care received by 100 critically- ill patients admitted to intensive care units in two hospitals in Southampton and Portsmouth found that in 54 cases the standard was "sub-optimal", and 26 of these patients died.

This was almost twice the death rate among the 20 patients whose care was judged to have been managed well. The patients had suffered heart attacks and road accidents and many were admitted from general wards to the intensive care unit with a range of conditions.

Dr Peter McQuillan, consultant in intensive care and anaesthesia at Queen Alexandra Hospital, Portsmouth, who co-ordinated the study, says in the British Medical Journal that emergency admissions have risen by 50 per cent since 1984 and that this rise in numbers should not be at the expense of quality of care. He says a "major re-evaluation" of the way acute care is provided is required.

The authors found there were delays affecting two thirds of the 54 patients who were not treated adequately, which meant they were admitted late into intensive care. Breathing and circulation problems were poorly managed before admission and the patients' condition was inadequately monitored.