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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/28642373/failure-of-falls-risk-screening-tools-to-predict-outcome-a-prospective-cohort-study
#1
Kristie J Harper, Annette D Barton, Glenn Arendts, Deborah G Edwards, Antonio C Petta, Antonio Celenza
OBJECTIVE: To compare the Falls Risk for Older Persons-Community Setting Screening Tool (FROP Com Screen) with the Two-Item Screening Tool in older adults presenting to the ED. METHODS: A prospective cohort study, comparing the efficacy of the two falls risk assessment tools by applying them simultaneously in a sample of hospital ED presentations. RESULTS: Two hundred and one patients over 65 years old were recruited. Thirty-six per cent reported falls in the 6-month follow-up period...
June 22, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28642372/the-highland-health-advocates-a-preliminary-evaluation-of-a-novel-programme-addressing-the-social-needs-of-emergency-department-patients
#2
Lia Ilona Losonczy, Dennis Hsieh, Michael Wang, Christopher Hahn, Tarak Trivedi, Marcela Rodriguez, Jahan Fahimi, Harrison Alter
OBJECTIVES: Patients commonly come to the emergency department (ED) with social needs. To address this, we created the Highland Health Advocates (HHA), an ED-based help desk and medical-legal partnership using undergraduate volunteers to help patients navigate public resources and provide onsite legal and social work referrals. We were able to provide these services in English and Spanish. We aimed to determine the social needs of the patients who presented to our ED and the potential impact of the programme in resolving those needs and connecting them to a 'medical home' (defined as a consistent, primary source of medical care such as a primary care doctor or clinic)...
June 22, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28637648/are-final-year-medical-students-ready-to-save-lives-in-italy-not-yet
#3
LETTER
Enrico Contri, Maria Concetta Bonomo, Giulia Costantini, Miriam Manera, Marco Bormetti, Michela Tonani, Enrico Baldi
No abstract text is available yet for this article.
June 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28626030/gender-race-and-the-presentation-of-acute-coronary-syndrome-and-serious-cardiopulmonary-diagnoses-in-ed-patients-with-chest-pain
#4
Ahmed Allabban, Judd E Hollander, Jesse M Pines
OBJECTIVE: To assess the relationship between reported chest pain symptoms and a diagnosis of acute coronary syndrome (ACS) and serious cardiopulmonary diagnoses (SCPD) in black males, white males, black females and white females. METHODS: This was a secondary analysis of a prospective cohort study of 4162 ED patients with chest pain enrolled between 1999 and 2008. We used logistic regression, adjusting for age and cardiovascular comorbidities to test the association between 24 chest pain symptoms and 30-day ACS for the primary outcome and SCPD as the secondary outcome...
June 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28606941/authors-response-extracorporeal-cardiopulmonary-resuscitation-probably-good-but-adoption-should-not-be-too-fast-and-furious
#5
LETTER
Brian Burns, Cliff Reid, Rob Scott, Stephen Bernard, Lionel Lamhaut, Joe Bellezzo, Zack Shinar, Mark Dennis, Paul Forrest
No abstract text is available yet for this article.
June 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28600450/establishing-a-legal-service-for-major-trauma-patients-at-a-major-trauma-centre-in-the-uk
#6
William H Seligman, Julian Thompson, Hannah E Thould, Charlotte Tan, Andrew Dinsmore, David J Lockey
BACKGROUND: Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. METHODS: In 2013, a legal service was established at North Bristol NHS Trust...
June 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28588013/building-a-visual-aid-for-a-triage-tool-in-a-developing-health-service
#7
Mir Saaduddin Ahmad, Darryl R Wood
Resources in the modern day emergency department are often stretched, and this holds true more so in developing services. With limited manpower, it is essential that efficient tools are created so that processes can be run safely. Here we pilot the use of a vital signs matrix in a medical camp in Dhaka to screen patients at triage. We further modified this matrix to include the National Early Warning Score as our recording of the NEWS have remained poor in triage. A trial and validation study for the use of this matrix in an NHS setting is currently underway...
June 6, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28522436/prognosis-of-undiagnosed-chest-pain-do-emergency-physicians-need-to-rethink-current-practice
#8
Edward Carlton
No abstract text is available yet for this article.
May 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28515132/inclusion-of-emergency-department-patients-in-early-stages-of-sepsis-in-a-quality-improvement-programme-has-the-potential-to-improve-survival-a-prospective-dual-centre-study
#9
Bas De Groot, Bastiaan Struyk, Rashed Najafi, Nieke Halma, Loekie Pelser, Denise Vorst, Bart Mertens, Annemieke Ansems, Douwe Rijpsma
STUDY OBJECTIVE: Sepsis quality improvement programmes typically focus on severe sepsis (ie, with acute organ failure). However, quality of ED care might be improved if these programmes included patients whose progression to severe sepsis could still be prevented (ie, infection without acute organ failure). We compared the impact on mortality of implementing a quality improvement programme among ED patients with a suspected infection with or without acute organ failure. METHODS: This prospective observational study among ED patients hospitalised with suspected infection was conducted in two hospitals in the Netherlands...
May 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28501816/emergency-medicine-pharmacists-on-an-international-scale
#10
EDITORIAL
Zlatan Coralic, Bryan D Hayes
No abstract text is available yet for this article.
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28501815/can-the-prehospital-national-early-warning-score-identify-patients-most-at-risk-from-subsequent-deterioration
#11
Joanna Shaw, Rachael T Fothergill, Sophie Clark, Fionna Moore
INTRODUCTION: The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition. METHODS: Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital...
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500089/an-exploration-of-patients-experiences-of-participation-in-a-randomised-controlled-trial-of-the-manchester-acute-coronary-syndromes-macs-decision-rule
#12
Patricia van den Berg, Sarah Kendal, Helen V Alderson, Richard Body
BACKGROUND: As an important part of a pilot study to determine the feasibility of a large randomised controlled trial (RCT) comparing use of the Manchester Acute Coronary Syndromes (MACS) decision rule with standard care, we aimed to explore patient attitudes and potential barriers to participation in a trial of this nature. METHODS: We conducted a qualitative study nested within a pilot RCT comparing use of the MACS rule (which could enable some patients with chest pain to be discharged earlier) with standard care...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500088/spotting-the-black-swan-why-emergency-medicine-is-ahead-of-the-curve
#13
EDITORIAL
Damian Roland
"Black Swans", originally described as an economic theory, are unexpected events whose potential to occur only becomes apparent after they have happened. The concept is very relevant to the practice of Emergency Medicine and this article explores how black swans impact on emergency care and how staff unconsciously aim to mitigate against them.
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500087/feasibility-of-the-manchester-acute-coronary-syndromes-macs-decision-rule-to-safely-reduce-unnecessary-hospital-admissions-a-pilot-randomised-controlled-trial
#14
Richard Body, Charles Boachie, Alex McConnachie, Simon Carley, Patricia Van Den Berg, Fiona E Lecky
BACKGROUND: Observational studies suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule can effectively 'rule out' and 'rule in' acute coronary syndromes (ACS) following a single blood test. In a pilot randomised controlled trial, we aimed to determine whether a large trial is feasible. METHODS: Patients presenting to two EDs with suspected cardiac chest pain were randomised to receive care guided by the MACS decision rule (intervention group) or standard care (controls)...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500086/detection-of-pneumothoraces-in-patients-with-multiple-blunt-trauma-use-and-limitations-of-efast
#15
Thomas C Sauter, Simon Hoess, Beat Lehmann, Aristomenis K Exadaktylos, Dominik G Haider
BACKGROUND: Extended focused assessment with sonography for trauma (eFAST) has been shown to have moderate sensitivity for detection of pneumothorax in trauma. Little is known about the location or size of missed pneumothoraces or clinical predictors of pneumothoraces in patients with false-negative eFAST. METHODS: This retrospective cross-sectional study includes all patients with multiple blunt trauma diagnosed with pneumothorax who underwent both eFAST and CT performed in the ED of a level 1 trauma centre in Switzerland between 1 June 2012 and 30 September 2014...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#16
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28487288/primary-care-services-co-located-with-emergency-departments-across-a-uk-region-early-views-on-their-development
#17
Suzanne Ablard, Colin O'Keeffe, Shammi Ramlakhan, Suzanne M Mason
BACKGROUND: Co-location of primary care services with Emergency Departments (ED) is one initiative aiming to reduce the burden on EDs of patients attending with non-urgent problems. However, the extent to which these services are operating within or alongside EDs is not currently known.This study aimed to create a typology of co-located primary care services in operation across Yorkshire and Humber (Y&H) as well as identify early barriers and facilitators to their implementation and sustainability...
May 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28483932/-major-trauma-now-two-separate-diseases
#18
EDITORIAL
Timothy J Coats, Fiona Lecky
No abstract text is available yet for this article.
May 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28483931/alcohol-identification-and-intervention-in-english-emergency-departments
#19
Robert Patton, Ghiselle Green
AIMS: In the ED, alcohol identification and brief advice is an effective method of reducing consumption and related harms. Our objective was to conduct a national survey of English EDs to determine current practice regarding alcohol identification and provision of brief advice and to compare changes in activity to a previous National Survey conducted in 2011. METHODS: This was a cross-sectional survey of all consultant-led EDs in England. RESULTS: Of 180 departments, 147 (81...
May 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28476730/mountain-rescue-cardiopulmonary-resuscitation-a-comparison-between-manual-and-mechanical-chest-compressions-during-manikin-cardio-resuscitation
#20
Oyvind Thomassen, Sven Christjar Skaiaa, Jorg Assmuss, Øyvind Østerås, Jon Kenneth Heltne, Lars Wik, Guttorm Brattebo
AIM: Chest compression devices are useful during mountain rescue but may cause a delay in transport if not immediately available. The aims of this prospective observational study were to compare manual and mechanical cardiopulmonary resuscitation (CPR) during transport on a sledge connected to a snowmobile with a non-moving setting and to compare CPR quality between manual and two mechanical chest compression devices. METHODS: Sixteen healthcare providers simulated four different combined CPR scenarios on a sledge in a non-moving setting and during transport and two mechanical chest compression devices during transport on the sledge...
May 5, 2017: Emergency Medicine Journal: EMJ
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