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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/28302644/what-is-an-roc-curve
#1
EDITORIAL
Zhe Hui Hoo, Jane Candlish, Dawn Teare
The paper by Body et al is concerned with the evaluation of decision aids, which can be used to identify potential acute coronary syndromes (ACS) in the ED. The authors previously developed the Manchester Acute Coronary Syndromes model (MACS) decision aid, which uses several clinical variables and two biomarkers to 'rule in' and 'rule out' ACS. However, one of the two biomarkers (heart-type fatty acid bindingprotein, H-FABP) is not widely used so a revised decision aid has been developed (Troponin-only Manchester Acute Coronary Syndromes, T-MACS), which include a single biomarker hs-cTnT...
March 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28289037/the-barriers-associated-with-emergency-medical-service-use-for-acute-coronary-syndrome-the-awareness-and-influence-of-an-australian-public-mass-media-campaign
#2
Susie Cartledge, Judith Finn, Lahn Straney, Phillip Ngu, Dion Stub, Harry Patsamanis, James Shaw, Janet Bray
BACKGROUND: Emergency medical services (EMS) transport to hospital is recommended in acute coronary syndrome (ACS) guidelines, but only half of patients with ACS currently use EMS. The recent Australian Warning Signs campaign conducted by the Heart Foundation addressed some of the known barriers against using EMS. Our aim was to examine the influence of awareness of the campaign on these barriers in patients with ACS. METHODS: Interviews were conducted with patients admitted to an Australian tertiary hospital between July 2013 and April 2014 with a diagnosis of ACS...
March 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28283538/what-do-emergency-physicians-in-charge-do-a-qualitative-observational-study
#3
Ian Hosking, Adrian Boyle, Vazeer Ahmed, John Clarkson
INTRODUCTION: The emergency physician in charge role has developed in many large EDs to assist with patient flow. We aimed to describe and classify the problem-solving actions that this role requires. METHODS: We interviewed senior emergency physicians and performed iterative, qualitative observations, using continuous reflective inquiry, in a single centre. We reviewed and classified these approaches by consensus. RESULTS: Nine different problem-solving approaches were identified...
March 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28270448/management-of-pregnancy-and-obstetric-complications-in-prehospital-trauma-care-prehospital-resuscitative-hysterotomy-perimortem-caesarean-section
#4
EDITORIAL
Emir Battaloglu, Keith Porter
The need for prehospital resuscitative hysterotomy/perimortem caesarean section is rare. The procedures can be daunting and clinically challenging for practitioners. Maternal death can be averted by swift and decisive action. This guideline serves to inform prehospital practitioners about conducting maternal resuscitation following cardiac arrest, provides an evidence-based framework to support decision making and highlights areas for improvement in prehospital care.
March 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28264877/management-of-pregnancy-and-obstetric-complications-in-prehospital-trauma-care-faculty-of-prehospital-care-consensus-guidelines
#5
E Battaloglu, K Porter
This consensus statement seeks to provide clear guidance for the management of pregnant trauma patients in the prehospital setting. Pregnant patients sustaining trauma injuries have certain clinical management priorities beyond that of the non-pregnant trauma patients and that if overlooked may be detrimental to maternal and fetal outcomes.
March 6, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28259845/extracorporeal-cardiopulmonary-resuscitation-probably-good-but-adoption-should-not-be-too-fast-and-furious
#6
EDITORIAL
Clifton W Callway, Kjetil Sunde
No abstract text is available yet for this article.
March 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28258097/lung-ultrasound-a-useful-tool-in-the-assessment-of-the-dyspnoeic-patient-in-the-emergency-department-fact-or-fiction
#7
REVIEW
Yashvi Wimalasena, Laura Kocierz, Dan Strong, Joanna Watterson, Brian Burns
Patients with respiratory distress present a frequent and challenging dilemma for emergency physicians (EPs). The accurate diagnosis and treatment of the underlying pathology is vitally important in these sick patients to ensure the best outcome and minimise harm from unnecessary treatments. Within the last decade, studies have shown lung ultrasonography (LU) to be valuable in the accurate diagnosis of a variety of lung pathologies, including cardiogenic pulmonary oedema, pleural effusion, pneumothorax, haemothorax and pneumonia...
March 3, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28254762/risk-stratification-of-survival-in-injured-patients-with-cardiopulmonary-resuscitation-within-the-first-hour-of-arrival-to-trauma-centre-retrospective-analysis-from-the-national-trauma-data-bank
#8
Nasim Ahmed, Patricia Greenberg, Victor M Johnson, John Mihran Davis
BACKGROUND: The purpose of this study was to evaluate overall survival and associated survival factors for patients with trauma who had cardiopulmonary resuscitation (CPR) within 1 hour after arrival to a hospital. METHODS: Retrospective patient data was retrieved from the 2007-2010 edition of the US National Trauma Data Bank. Inhospital survival was the primary outcome; only patients with a known outcome were included in the analysis. Summary statistics and univariate analyses were first reported...
March 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28249938/remifentanil-for-procedural-sedation-a-systematic-review-of-the-literature
#9
Magdalena Kisilewicz, Hans Rosenberg, Christian Vaillancourt
OBJECTIVE: We sought to determine the performance characteristics of remifentanil as an agent of procedural sedation and analgesia (PSA) for adult and paediatric patients undergoing procedures similar to those executed in the ED. METHODS: We systematically reviewed electronically published literature, grey literature, conference proceedings and trial registries from 1946 to 2015. Outcome measures included PSA effectiveness, recovery time, patient safety and resource management...
March 1, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28228473/violence-related-ambulance-call-outs-in-the-north-west-of-england-a-cross-sectional-analysis-of-nature-extent-and-relationships-to-temporal-celebratory-and-sporting-events
#10
Zara Quigg, Ciara McGee, Karen Hughes, Simon Russell, Mark A Bellis
OBJECTIVE: The aim of this study was to explore the potential of ambulance call-out data in understanding violence to inform about prevention activity. METHOD: This cross-sectional (2013-2015) study examined the nature, extent and characteristics of violence-related ambulance call-outs (n=15 687) across North West England and relationships with temporal, celebratory and sporting events. RESULTS: The majority of call-outs were for men, with a mean age of 33 years...
February 21, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28213587/emergency-extracorporeal-life-support-and-ongoing-resuscitation-a-retrospective-comparison-for-refractory-out-of-hospital-cardiac-arrest
#11
A Schober, F Sterz, H Herkner, C Wallmueller, C Weiser, P Hubner, C Testori
BACKGROUND: In refractory cardiac arrest, with cardiopulmonary resuscitation (CPR) for more than 30 min, chances of survival are small. Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for certain patients with cardiac arrest. The aim of this study was to evaluate characteristics of patients selected for ECPR. METHODS: Anonymised data of adult patients suffering refractory cardiac arrest, transported with ongoing CPR to an ED of a tertiary care centre between 2002 and 2012 were analysed...
February 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28188203/emergency-department-syndromic-surveillance-to-investigate-the-health-impact-and-factors-associated-with-alcohol-intoxication-in-reunion-island
#12
Pascal Vilain, Sophie Larrieu, Katia Mougin-Damour, Pierre-Jean Marianne Dit Cassou, Marc Weber, Xavier Combes, Laurent Filleul
In Reunion Island, alcohol is the most tried out psychoactive substance. To our knowledge, few indicators measuring the health burden of alcohol use exist on the island. In this context, an exploratory analysis based on syndromic surveillance data was implemented in order to describe the emergency department (ED) visits for alcohol intoxication (AI) and factors associated with their variations.An analysis of anonymized records routinely collected by the syndromic surveillance system was carried out. A daily indicator of ED visits for AI was built from a selection of ICD-10 codes between 2010 and 2012...
February 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28188202/progressive-prediction-of-hospitalisation-in-the-emergency-department-uncovering-hidden-patterns-to-improve-patient-flow
#13
Yuval Barak-Corren, Shlomo Hanan Israelit, Ben Y Reis
INTRODUCTION: One of the factors contributing to ED crowding is the lengthy delay in transferring an admitted patient from the ED to an inpatient department (ie, boarding time). An earlier start of the admission process using an automatic hospitalisation prediction model could potentially shorten these delays and reduce crowding. METHODS: Clinical, operational and demographic data were retrospectively collected on 80 880 visits to the ED of Rambam Health Care Campus in Haifa, Israel, from January 2011 to January 2012...
February 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28183715/peering-through-the-hourglass
#14
EDITORIAL
Jay Lemery
No abstract text is available yet for this article.
February 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28153866/development-of-a-trigger-tool-to-identify-adverse-events-and-harm-in-emergency-medical-services
#15
Ian Lucas Howard, James Marcus Bowen, Loua Asad Hanna Al Shaikh, Kedar Shrikrishna Mate, Robert Campbell Owen, David Michael Williams
BACKGROUND: Adverse event (AE) detection in healthcare has traditionally relied upon several methods including: patient care documentation review, mortality and morbidity review, voluntary reporting, direct observation and complaint systems. A novel sampling strategy, known as the trigger tool (TT) methodology, has been shown to provide a more robust and valid method of detection. The aim of this research was to develop and assess a TT specific to ground-based Emergency Medical Services, to identify cases with the potential risk for adverse events and harm...
February 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28143813/the-use-of-history-to-identify-anterior-cruciate-ligament-injuries-in-the-acute-trauma-setting-the-limp-index
#16
Colin Ayre, Maryann Hardy, Andrew Scally, Graham Radcliffe, Ram Venkatesh, Jon Smith, Stephen Guy
OBJECTIVE: To identify the injury history features reported by patients with anterior cruciate ligament (ACL) injuries and determine whether history may be used to identify patients requiring follow-up appointments from acute trauma services. METHODS: Multisite cross-sectional service evaluation using a survey questionnaire design conducted in the UK. The four injury history features investigated were 'leg giving way at the time of injury', 'inability to continue activity immediately following injury', 'marked effusion' and 'pop (heard or felt) at the time of injury'(LIMP)...
January 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28130348/can-surf-lifeguards-perform-a-quality-cardiopulmonary-resuscitation-sailing-on-a-lifeboat-a-quasi-experimental-study
#17
Roberto Barcala-Furelos, Cristian Abelairas-Gomez, Jose Palacios-Aguilar, Ezequiel Rey, Javier Costas-Veiga, Sergio Lopez-Garcia, Antonio Rodriguez-Nunez
PURPOSE: Drowning is a high-priority public health problem around the world. The European Resuscitation Council Guidelines for Resuscitation 2015 put special emphasis on special environments like open waters. Stopping the drowning process as soon as possible and starting an early cardiopulmonary resuscitation (CPR) improve survival. Inflatable rescue boats (IRBs) are used around the world in the water rescue of drowning victims. Our objective was to test the quality of CPR performed by surf-lifeguards while sailing on an IRB...
January 27, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28130347/non-traumatic-incidental-findings-in-patients-undergoing-whole-body-computed-tomography-at-initial-emergency-admission
#18
Eduard K Kroczek, Gero Wieners, Ingo Steffen, Tobias Lindner, Florian Streitparth, Bernd Hamm, Martin H Maurer
OBJECTIVE: To evaluate the number, localisation and importance of non-traumatic incidental findings (IFs) in patients with suspected or obvious multiple trauma undergoing whole-body CT (WBCT) in a level-1 trauma centre. METHODS: Between January 2009 and December 2013, a total of 2440 patients with trauma undergoing WBCT at admission to a level-1 trauma centre of a university hospital were retrospectively analysed, through imaging IFs unrelated to trauma with the radiological reports...
January 27, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28130346/the-use-of-whole-body-computed-tomography-in-major-trauma-variations-in-practice-in-uk-trauma-hospitals
#19
Ian Ayenga Sammy, Hridesh Chatha, Omar Bouamra, Marisol Fragoso-Iñiguez, Fiona Lecky, Antoinette Edwards
INTRODUCTION: Whole-body CT (WBCT) use in patients with trauma in England and Wales is not well documented. WBCT in trauma can reduce time to definitive care, thereby increasing survival. However, its use varies significantly worldwide. METHODS: We performed a retrospective observational study of Trauma Audit and Research Network (TARN) data from 2012 to 2014. The proportion of adult patients receiving WBCT during initial resuscitation at major trauma centres (MTCs) and trauma units/non-designated hospitals (TUs/NDHs) was compared...
January 27, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28119351/are-first-rib-fractures-a-marker-for-other-life-threatening-injuries-in-patients-with-major-trauma-a-cohort-study-of-patients-on-the-uk-trauma-audit-and-research-network-database
#20
Ian Ayenga Sammy, Hridesh Chatha, Fiona Lecky, Omar Bouamra, Marisol Fragoso-Iñiguez, Abdo Sattout, Michael Hickey, John E Edwards
BACKGROUND: First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted. METHODS: Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network...
January 24, 2017: Emergency Medicine Journal: EMJ
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