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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/29784644/correction-bet-2-blood-biomarkers-as-an-alternative-to-imaging-in-diagnosing-acute-ischaemic-stroke
#1
(no author information available yet)
No abstract text is available yet for this article.
May 21, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29769232/end-tidal-carbon-dioxide-output-in-manual-cardiopulmonary-resuscitation-versus-active-compression-decompression-device-during-prehospital-quality-controlled-resuscitation-a-case-series-study
#2
Piritta Anniina Setälä, Ilkka Tapani Virkkunen, Antti Jaakko Kämäräinen, Heini Sisko Annamari Huhtala, Janne Severi Virta, Arvi Mikael Yli-Hankala, Sanna Elisa Hoppu
BACKGROUND: Active compression-decompression (ACD) devices have enhanced end-tidal carbon dioxide (ETCO2 ) output in experimental cardiopulmonary resuscitation (CPR) studies. However, the results in out-of-hospital cardiac arrest (OHCA) patients have shown inconsistent outcomes, and earlier studies lacked quality control of CPR attempts. We compared manual CPR with ACD-CPR by measuring ETCO2 output using an audiovisual feedback defibrillator to ensure continuous high quality resuscitation attempts...
May 16, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29748230/senior-doctor-triage-sdt-a-qualitative-study-of-clinicians-views-on-senior-doctors-involvement-in-triage-and-early-assessment-of-emergency-patients
#3
Maysam Ali Abdulwahid, Janette Turner, Suzanne M Mason
INTRODUCTION: Despite the focus during the last decade on introducing interventions such as senior doctor initial assessment or senior doctor triage (SDT) to reduce emergency department (ED) crowding, there has been little attempt to identify the views of emergency healthcare professionals on such interventions. The aim of this study was to gain an understanding of SDT from the perspective of emergency hospital staff. A secondary aim of this study was to develop a definition of SDT based on the interview findings and the available literature on this process...
May 10, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29728411/prehospital-haemostatic-dressings-for-trauma-a-systematic-review
#4
Adam J Boulton, Christopher T Lewis, David N Naumann, Mark J Midwinter
BACKGROUND: Haemorrhage is a major cause of mortality and morbidity following both military and civilian trauma. Haemostatic dressings may offer effective haemorrhage control as part of prehospital treatment. AIM: To conduct a systematic review of the clinical literature to assess the prehospital use of haemostatic dressings in controlling traumatic haemorrhage, and determine whether any haemostatic dressings are clinically superior. METHODS: MEDLINE and EMBASE databases were searched using predetermined criteria...
May 4, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29728410/what-is-the-normal-haemodynamic-response-to-passive-leg-raise-a-study-of-healthy-volunteers
#5
Mohammed H Elwan, Ashraf Roshdy, Joseph A Reynolds, Eman M Elsharkawy, Salah M Eltahan, Timothy J Coats
OBJECTIVE: Passive leg raise (PLR) is used as self-fluid challenge to optimise fluid therapy by predicting preload responsiveness. However, there remains uncertainty around the normal haemodynamic response to PLR with resulting difficulties in application and interpretation in emergency care. We aim to define the haemodynamic responses to PLR in spontaneously breathing volunteers using a non-invasive cardiac output monitor, thoracic electrical bioimpedance, TEB (PLR-TEB). METHODS: We recruited healthy volunteers aged 18 or above...
May 4, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29720476/sepsis-3-and-simple-rules
#6
EDITORIAL
Bernard A Foëx
No abstract text is available yet for this article.
May 2, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29720475/comparison-of-qsofa-with-current-emergency-department-tools-for-screening-of-patients-with-sepsis-for-critical-illness
#7
Robert M Rodriguez, John C Greenwood, Thomas J Nuckton, Bryan Darger, Frances S Shofer, Dawn Troeger, Soo Y Jung, Kelly G Speich, Joel Valencia, J Hope Kilgannon, Danny Fernandez, Brigitte M Baumann
OBJECTIVE: We sought to compare the quick sequential organ failure assessment (qSOFA) to systemic inflammatory response syndrome (SIRS), severe sepsis criteria and lactate levels for their ability to identify ED patients with sepsis with critical illness. METHODS: We conducted this multicenter retrospective cohort study at five US hospitals, enrolling all adult patients admitted to these hospitals from their EDs with infectious disease-related illnesses from 1 January 2016 to 30 April 2016...
May 2, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29706595/sex-differences-in-mortality-among-critically-ill-children-in-pakistan
#8
LETTER
Marion Campbell
No abstract text is available yet for this article.
April 29, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#9
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29705729/man-with-hand-pain
#10
Paul S Jansson, Stella J Lee, Margaret E Samuels-Kalow
No abstract text is available yet for this article.
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29703777/prehospital-neurological-deterioration-in-stroke
#11
Sabreena J Slavin, Heidi Sucharew, Kathleen Alwell, Charles J Moomaw, Daniel Woo, Opeolu Adeoye, Matthew L Flaherty, Simona Ferioli, Jason McMullan, Jason Mackey, Felipe De Los Rios La Rosa, Sharyl Martini, Brett M Kissela, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: Patients with stroke can experience neurological deterioration in the prehospital setting. We evaluated patients with stroke to determine factors associated with prehospital neurological deterioration (PND). METHODS: Among the Greater Cincinnati/Northern Kentucky region (population ~1.3 million), we screened all 15 local hospitals' admissions from 2010 for acute stroke and included patients aged ≥20. The GCS was compared between emergency medical services (EMS) arrival and hospital arrival, with decrease ≥2 points considered PND...
April 27, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29691305/application-of-outpatient-cardiac-testing-among-emergency-department-patients-with-syncope
#12
Olivia G Cook, Muhammad A Mukarram, Soo-Min Kim, Kirtana Arcot, Marie-Joe Nemnom, Monica Taljaard, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: 2.6% of ED syncope patients will suffer cardiac serious adverse events (SAEs) within 30 days of disposition, and outpatient cardiac testing can improve patient safety. The objective is to determine whether outpatient cardiac testing for ED syncope patients is being appropriately ordered after discharge. To this end, we describe the proportion of high-risk and non-high (low and medium)-risk ED syncope patients as per the Canadian Syncope Risk Score (CSRS) who have a SAE after ED discharge, and the proportion referred for outpatient cardiac testing...
April 24, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29666145/development-of-sustainable-community-paramedicine-programmes-a-case-study-in-pennsylvania
#13
Yuan-Han Huang, Linlin Ma, Luke A Sabljak, Zachary A Puhala
BACKGROUND: Community paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development. METHODS: A series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively...
April 17, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29661780/gender-and-survival-from-out-of-hospital-cardiac-arrest-a-new-zealand-registry-study
#14
Bridget Dicker, Kate Conaglen, Graham Howie
OBJECTIVE: To determine the relationships between survival from all-cause out-of-hospital cardiac arrest (OHCA) and gender in New Zealand. METHODS: A retrospective observational study was conducted using data compliant with the Utstein guidelines from the St John New Zealand OHCA Registry for adult patients who were treated for an OHCA between 1 October 2013 and 30 September 2015. Univariate logistic regression was used to investigate factors associated with return of spontaneous circulation sustained to handover at hospital and survival to 30 days...
April 16, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29627770/essential-medicines-for-emergency-care-in-africa
#15
Morgan C Broccoli, Jennifer L Pigoga, Mulinda Nyirenda, Lee Wallis, Emilie J Calvello Hynes
OBJECTIVES: Essential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury. METHODS: We undertook a multistep consensus process to establish an EML for emergency care in Africa...
April 7, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29627769/development-and-validation-of-an-admission-prediction-tool-for-emergency-departments-in-the-netherlands
#16
Nicole Kraaijvanger, Douwe Rijpsma, Lian Roovers, Henk van Leeuwen, Karin Kaasjager, Lillian van den Brand, Laura Horstink, Michael Edwards
OBJECTIVE: Early prediction of admission has the potential to reduce length of stay in the ED. The aim of this study is to create a computerised tool to predict admission probability. METHODS: The prediction rule was derived from data on all patients who visited the ED of the Rijnstate Hospital over two random weeks. Performing a multivariate logistic regression analysis factors associated with hospitalisation were explored. Using these data, a model was developed to predict admission probability...
April 7, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29622596/risk-stratifying-chest-pain-patients-in-the-emergency-department-using-heart-grace-and-timi-scores-with-a-single-contemporary-troponin-result-to-predict-major-adverse-cardiac-events
#17
Peter D W Reaney, Hamish I Elliott, Awsan Noman, Jamie G Cooper
BACKGROUND: The majority of patients presenting to the ED with cardiac sounding chest pain have a non-diagnostic ECG and the problem of differentiating those suffering an acute coronary syndrome from those without is familiar to all ED clinical staff. To stratify risk in these patients, specific scores have been developed. Recent work has focused on incorporating newer high-sensitivity cardiac troponin (hs-cTn) assays; however, issues regarding performance and availability of these assays remain...
April 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29599111/absence-of-a-quick-fix-does-not-mean-do-nothing-time-to-address-drug-use-in-the-ed
#18
EDITORIAL
Richard Saitz
No abstract text is available yet for this article.
March 29, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29572386/marauding-terrorist-attack-mta-prehospital-considerations
#19
Ravi Chauhan, Bianca M Conti, Damian Keene
Terrorist attacks are increasing each year as are the number of deaths associated with them. Recent incidents have seen a shift in tactics with the use of multiple terrorists across multiple locations with firearms or knives, referred to as the marauding terrorist attack. These methods are becoming more prevalent alongside the use of vehicles deliberately aimed at pedestrians. Management of these incidents can be challenging. Not only it involves a large number of casualties but also the management of a dynamic scene in terms of both location and threat from attack...
March 23, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29563151/emergency-department-overcrowding-a-survey-among-european-neurotrauma-centres
#20
Kimberley Bernadette Velt, Maryse Cnossen, Pleunie P M Rood, Ewout W Steyerberg, Suzanne Polinder, Hester F Lingsma
BACKGROUND: ED overcrowding is an increasing problem worldwide that may negatively affect quality of care and patient outcomes. We aimed to study ED overcrowding across European centres. METHODS: Questionnaires on structure and process of care, including crowding, were distributed to 68 centres participating in a large European study on traumatic brain injury (Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury). RESULTS: Of the 65 centres included in the analysis, 32 (49%) indicated that overcrowding was a frequent problem and 28 (43%) reported that patients were placed in hallways 'multiple times a day'; 27 (41%) stated that multiple times a day, there was no bed available when a patient needed to be admitted...
March 21, 2018: Emergency Medicine Journal: EMJ
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