Caring for patients in mental health services during COVID-19 outbreak in China

This article reflects on some radical changes made in mental health services in China which include the implementation of the initial triage system and the special isolation ward, the early screening and testing for both patients and staff, the smaller teams working on rotating shifts on-site, and the adequate provision of PPE. These measures would be of great value as a reference to the effective delivery of mental health services in other countries through this pandemic.

TRIAGE AND EMERGENCY MEDICAL MANAGEMENT OF THE ACUTE RADIATION SYNDROME

Introduction: Medical personnel of the state Emergency Medical Services (EMS) will be the first element involved in providing assistance to victims of radiation incidents. Triage, initial diagnosis and further patient medical management will depend on their actions. In many radiation incidents, initial radiation triage and early diagnostics will be carried out in the emergency department (ED) or trauma center (TC). Extended triage, diagnosis of ARS and proper treatment will be continued in specialist centers. The aim: To present a model of patient medical management including initial triage and early diagnosis of ARS that can be carried out at the ED and TC. Material and methods: The initial medical procedures prepared by expert groups were presented. The choice of procedures was made in terms of the possibility of their application by the EMS teams in Poland. Particular attention was paid to the method of initial triage, based on the clinical condition and laboratory diagnostics. Results: Based on the material collected, the path of the initial medical procedure was presented. Variants of the radiation triage, interpretation of clinical parameters and results of laboratory tests are presented. The methods of initial treatment and the method of qualification for specialist treatment, and new methods of treating patients were also described. Conclusions: An adequate evaluation of radiation incidents, determining the absorbed dose of ionising radiation and ARS, as well as initial triage seem to be crucial skills of the EMS workers.

Social Workers under the Spotlight: An Analysis of Fitness to Practise Referrals to the Regulatory Body in England, 2014–2016

This article examines the nature of, and reasons for, the disproportionately high rates of fitness to practise referrals of social workers in England to the Health and Care Professions Council (HCPC), compared with other professions regulated by HCPC during 2014–2016. In 2014–2015, the rate of referrals for social workers was 1.42 per cent of registrants, compared with an average for the sixteen professions regulated by HCPC of 0.66 per cent. Drawing on published statistics and unique analysis of a sample of 232 case files undertaken as part of a research project in 2016–2017, the article highlights relatively high rates of inappropriate referrals from ‘members of the public’ (mainly service users) particularly in relation to child placements and contact. A detailed picture is offered of the variety of referrals dealt with at each stage of the fitness to practise process (from initial triage to final hearings), with recommendations for how to prevent inappropriate referrals, whilst focusing concern on the most serious cases of incompetence and misconduct. This research is of significance at a time of increasing pressure for social workers, social services and service users under conditions of austerity and managerialism; on-going concerns about standards in social work; and recent changes in social work regulation.