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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/29326239/what-is-positionality-and-should-it-be-expressed-in-quantitative-studies
#1
EDITORIAL
Anisa J N Jafar
Although we are increasingly reaping the benefits of qualitative studies, their approach and that of quantitative studies remain rather separate. Emergency medicine practitioners thrive off research in context as we deal with such an undifferentiated population however quantitative 'hard-science' work is conspicuous for its absence of positionality. This contrasts strongly with the way in which qualitative research, within the domain of so-called soft-science literature, uses positionality as an integral element of the research process...
January 11, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29321209/issues-and-challenges-for-research-in-major-trauma
#2
EDITORIAL
Sharon Ann Swain, Graham Stiff
The starting point for evidence-based guidelines is the systematic review and critical appraisal of the relevant literature. This review highlights the risk of bias identified while critically appraising the evidence to inform the National Institute of Health and Care Excellence guideline on the assessment and initial management of major trauma.
January 10, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29311114/frequent-use-of-emergency-departments-for-mental-and-substance-use-disorders
#3
Karen Urbanoski, Joyce Cheng, Jürgen Rehm, Paul Kurdyak
OBJECTIVES: We described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD. METHODS: This retrospective observational study included all Ontario residents 15 years and older who had five or more ED visits during any 12-month period from 2010 to 2012 (n=263 346)...
January 8, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29305381/thirty-day-hospital-readmissions-among-mechanically-ventilated-emergency-department-patients
#4
David B Page, Anne M Drewry, Enyo Ablordeppey, Nicholas M Mohr, Marin H Kollef, Brian M Fuller
BACKGROUND: Unplanned 30-day readmissions have a negative impact on patients and healthcare systems. Mechanically ventilated ED patients are at high risk for complications, but factors associated with readmission are unknown. OBJECTIVE: (1) Determine the rate of 30-day hospital readmission for ED patients receiving mechanical ventilation. (2) Identify associations between ED-based risk factors and readmission. DESIGN: Retrospective cohort study...
January 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29305380/beyond-prognostication-ambulance-personnel-s-lived-experiences-of-cardiac-arrest-decision-making
#5
Natalie Elizabeth Anderson, Merryn Gott, Julia Slark
INTRODUCTION: The purpose of this study was to explore ambulance personnel's decisions to commence, continue, withhold or terminate resuscitation efforts for patients with out-of-hospital cardiac arrest. METHOD: Semistructured interviews with a purposive sample of 16 demographically diverse ambulance personnel, currently employed in a variety of emergency ambulance response roles, around New Zealand. RESULTS: Participants sought and integrated numerous factors, beyond established prognostic indicators, when making resuscitation decisions...
January 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29305379/short-stay-admissions-at-an-inner-city-hospital-a-cross-sectional-analysis
#6
Ian Pope, Sharif Ismail, Benjamin Bloom, Gwyneth Jansen, Helen Burn, David McCoy, Tim Harris
OBJECTIVE: To investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs). METHOD: This is a retrospective analysis of attendance and discharge data from an inner-city ED in England for December 2013. The primary outcome was admission for less than 48 hours either to an inpatient unit or CDU. Variables included: age, gender, ethnicity, deprivation score, arrival date and time, arrival method, admission outcome and discharge diagnosis...
January 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29247042/intravenous-versus-oral-paracetamol-for-acute-pain-in-adults-in-the-emergency-department-setting-a-prospective-double-blind-double-dummy-randomised-controlled-trial
#7
Jeremy Furyk, Deahnne Levas, Benjamin Close, Kathryn Laspina, Meghan Fitzpatrick, Kelvin Robinson, Venkat N Vangaveti, Robin Ray
OBJECTIVE: To determine if intravenous paracetamol was superior to oral paracetamol as an adjunct to opioids in the management of moderate to severe pain in the ED setting. METHODS: A prospective, randomised, double-blind, double-dummy, controlled trial was conducted at a single academic tertiary care ED. Adult patients with moderate to severe pain were randomly assigned to receive either the intravenous paracetamol or oral paracetamol. The primary outcome was Visual Analogue Scale (VAS) pain reduction at 30 min...
December 15, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29222336/taking-control-of-alcohol-related-emergency-department-visits
#8
EDITORIAL
Fiona Wisniacki
No abstract text is available yet for this article.
December 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29212785/brief-history-of-the-specialty-of-emergency-medicine
#9
REVIEW
David John Williams
This is a brief overview of the development of the specialty of Emergency Medicine from small beginnings fifty years ago. It describes how the specialty evolved simultaneously in the UK and the USA and later in Australasia and Europe.
December 6, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29183919/managing-alcohol-related-attendances-in-emergency-care-can-diversion-to-bespoke-services-lessen-the-burden
#10
EDITORIAL
Andy Irving, Steve Goodacre, Joanne Blake, Davina Allen, Simon C Moore
Acute alcohol intoxication (AAI) has a long history of burdening emergency care services. Healthcare systems around the world have explored a variety of different services that divert AAI away from EDs to better manage their condition. Little formal evaluation has been undertaken, particularly in the UK where alcohol misuse is one of the highest in the world. In this article, we outline a brief history of diversionary services, introduce the concept of Alcohol Intoxication Management Services (AIMS) and describe examples of AIMS in the UK...
November 28, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29175878/ionised-calcium-levels-in-major-trauma-patients-who-received-blood-en-route-to-a-military-medical-treatment-facility
#11
Tony Kyle, Ian Greaves, Anthony Beynon, Vicky Whittaker, Mike Brewer, Jason Smith
BACKGROUND: Hypocalcaemia is a common metabolic derangement in critically ill patients. Blood transfusion can also contribute to depleted calcium levels. The aims of this study were to identify the incidence of hypocalcaemia in military trauma patients receiving blood products en route to a deployed hospital facility and to determine if intravenous calcium, given during the prehospital phase, has an effect on admission calcium levels. METHODS: This was a retrospective review of patients transported by the UK Medical Emergency Response Team in Afghanistan between January 2010 and December 2014 who were treated with blood products in the prehospital setting...
November 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29175877/the-feasibility-of-an-interactive-voice-response-system-ivrs-for-monitoring-patient-safety-after-discharge-from-the-ed
#12
Lisa A Calder, A Adam Cwinn, Mathieu Gatien, Andrew Gee, Natasha Larocque, Samantha Calder-Sprackman, Ria De Gorter, Jennifer Zlepnig, Ian G Stiell, Alan J Forster
BACKGROUND: Return ED visits are frequent and may be due to adverse events: adverse outcomes related to healthcare received. An interactive voice response system (IVRS) is a technology that translates human telephone input into digital data. Use of IVRS has been explored in many healthcare settings but to a limited extent in the ED. We determined the feasibility of using an IVRS to assess for adverse events after ED discharge. METHODS: This before and after study assessed detection of adverse events among consecutive high-acuity patients discharged from a tertiary care ED pre-IVRS and post-IVRS over two 2-week periods...
November 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29175876/what-we-can-learn-from-global-emergency-medicine
#13
EDITORIAL
Najeeb Rahman
No abstract text is available yet for this article.
November 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29117989/elevated-mortality-among-weekend-hospital-admissions-is-not-associated-with-adoption-of-seven-day-clinical-standards
#14
Rachel Meacock, Matt Sutton
INTRODUCTION: Patients admitted to hospital in an emergency at weekends have been found to experience higher mortality rates than those admitted during the week. The National Health Service (NHS) in England has introduced four priority clinical standards for emergency hospital care with the objective of reducing deaths associated with this 'weekend effect'. This study aimed to determine whether adoption of these clinical standards is associated with the extent to which weekend mortality is elevated...
November 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29102923/a-traumatic-tale-of-two-cities-does-ems-level-of-care-and-transportation-model-affect-survival-in-patients-with-trauma-at-level-1-trauma-centres-in-two-neighbouring-canadian-provinces
#15
Colin Rouse, Jefferson Hayre, James French, Jacqueline Fraser, Ian Watson, Susan Benjamin, Allison Chisholm, Beth Sealy, Mete Erdogan, Robert S Green, George Stoica, Paul Atkinson
BACKGROUND: Two distinct Emergency Medical Services (EMS) systems exist in Atlantic Canada. Nova Scotia operates an Advanced Emergency Medical System (AEMS) and New Brunswick operates a Basic Emergency Medical System (BEMS). We sought to determine if survival rates differed between the two systems. METHODS: This study examined patients with trauma who were transported directly to a level 1 trauma centre in New Brunswick or Nova Scotia between 1 April 2011 and 31 March 2013...
November 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29084730/calculating-the-proportion-of-avoidable-attendances-at-uk-emergency-departments-analysis-of-the-royal-college-of-emergency-medicine-s-sentinel-site-survey-data
#16
Toby Morris, Suzanne M Mason, Chris Moulton, Colin O'Keeffe
INTRODUCTION: Avoidable attendances (AAs; defined as non-urgent, self-referred patients who could be managed more effectively and efficiently by other services) have been identified as a contributor to ED crowding. Internationally, AAs have been estimated to constitute 10%-90% of ED attendances, with the UK 2013 Urgent and Emergency Care Review suggesting a figure of 40%. METHODS: This pilot study used data from the Royal College of Emergency Medicine's Sentinel Site Survey to estimate the proportion of AAs in 12 EDs across England on a standard day (20 March 2014)...
October 30, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29247139/correction-testing-of-the-always-events-approach-to-improve-the-patient-experience-in-the-emergency-department
#17
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29247138/bet-2-nsais-and-chickenpox
#18
Karen Stone, Emma Tackley, Sandra Weir
A shortcut review was carried out to establish whether non-steroidal anti-inflammatory drugs (NSAIDs) is safe to prescribe in patients with chicken pox. 66 unique papers were found in CINAHL, Medline, Embase and Cochrane using the reported searches of which 6 presented the best evidence to answer the clinical question. The author, date and country of publication; patient group studied; study type; relevant outcomes; results and study weaknesses of these best papers are tabulated. It is concluded that, pending further research, it is advisable to avoid NSAID use in cases of primary varicella due to the potential increased risk of severe bacterial skin infections...
January 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29247136/bet-1-continuous-flow-insufflation-of-oxygen-in-out-of-hospital-cardiac-arrest
#19
Pierre-Alexandre LeBlanc, Alexandra Nadeau
A short cut review was carried out to establish whether continuous flow insufflation of oxygen (CFIO) is better than standard ventilation strategies at improving outcome in adults who have suffered an out-of-hospital cardiac arrest (OHCA). Papers were found in Medline and Embase using the reported searches of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated...
January 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29247135/don-t-neglect-the-clock-drawing-test
#20
Michal Vinker Shuster, Maayan Hannah, Zalut Todd
INTRODUCTION: A 63-year-old, right-handed woman with a history of hypertension presented to the ED with left arm paresis of 2 days duration. Three weeks before admission, she had flu-like symptoms with intermittent left arm weakness that had recovered briefly but recurred 2 days prior to her presentation. On neurological examination, GCS was 15 and cranial nerves' function was normal. Left upper limb strength was 4/5. There was left arm drift and pronation but the patient denied noticing any difference between the positions of her arms...
January 2018: Emergency Medicine Journal: EMJ
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