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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/28899923/a-retrospective-analysis-of-34-potentially-missed-cases-of-female-genital-mutilation-in-the-emergency-department
#1
Richard John Fawcett, George Kernohan
OBJECTIVES: To discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law. DESIGN: A retrospective analysis of patients' notes who were assigned an FGM code during the period of May 2015 to August 2016. SETTING: Single-centre, large UK major trauma centre offering a tertiary FGM clinic. PARTICIPANTS: Any woman coded during the study period as having undergone FGM...
September 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28899922/changes-in-admission-thresholds-in-english-emergency-departments
#2
Steven Wyatt, Kieran Child, Andrew Hood, Matthew Cooke, Mohammed A Mohammed
BACKGROUND: The most common route to a hospital bed in an emergency is via an Emergency Department (ED). Many recent initiatives and interventions have the objective of reducing the number of unnecessary emergency admissions. We aimed to assess whether ED admission thresholds had changed over time taking account of the casemix of patients arriving at ED. METHODS: We conducted a retrospective cross-sectional analysis of more than 20 million attendances at 47 consultant-led EDs in England between April 2010 and March 2015...
September 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28870995/one-hundred-years-on-ypres-and-atls
#3
Rachael Sv Parker, Paul J Parker
No abstract text is available yet for this article.
September 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28860179/fewer-reboa-complications-with-smaller-devices-and-partial-occlusion-evidence-from-a-multicentre-registry-in-japan
#4
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tokiya Ishida, Yuri Kon, Keisuke Tomita, Kenichiro Ishida, Tomoya Hirose, Kensuke Umakoshi, Tomohiro Funabiki
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) performed by emergency physicians has been gaining acceptance as a less invasive technique than resuscitative thoracotomy. OBJECTIVE: To evaluate access-related complications and duration of occlusions during REBOA. METHODS: Patients with haemorrhagic shock requiring REBOA, from 18 hospitals in Japan, included in the DIRECT-IABO Registry were studied. REBOA-related characteristics were compared between non-survivors and survivors at 24 hours...
August 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28860178/can-more-appropriate-support-and-services-be-provided-for-people-who-attend-the-emergency-department-frequently-national-health-service-staff-views
#5
Suzanne Ablard, Elizabeth Coates, Cindy Cooper, Glenys Parry, Suzanne M Mason
BACKGROUND: Interventions designed to help Emergency Department (ED) staff manage frequent attenders are labour-intensive and only benefit a small sample of frequent attenders. We aimed to use the in-depth knowledge of health professionals with experience of working with ED frequent attenders to understand the challenges of managing this group of patients and their opinions on providing more appropriate support. METHODS: Semi-structured interviews were conducted with medical and nursing ED staff, mental health liaison nurses and general practitioners (GPs)...
August 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28855237/predict-prioritisation-study-establishing-the-research-priorities-of-paediatric-emergency-medicine-physicians-in-australia-and-new-zealand
#6
Heather Carol Deane, Catherine L Wilson, Franz E Babl, Stuart R Dalziel, John Alexander Cheek, Simon S Craig, Ed Oakley, Meredith Borland, Nicholas G Cheng, Michael Zhang, Elizabeth Cotterell, Tibor Schuster, David Krieser
BACKGROUND: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work. OBJECTIVE: To identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand. METHODS: Online surveys were administered in a two-stage, modified Delphi study...
August 30, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28844039/relationship-between-non-technical-skills-and-technical-performance-during-cardiopulmonary-resuscitation-does-stress-have-an-influence
#7
Ralf Krage, Laura Zwaan, Lian Tjon Soei Len, Mark W Kolenbrander, Dick van Groeningen, Stephan A Loer, Cordula Wagner, Patrick Schober
BACKGROUND: Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present...
August 26, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28823990/whole-body-computed-tomography-for-trauma-friend-or-foe
#8
EDITORIAL
Caroline Leech
No abstract text is available yet for this article.
August 20, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28821492/use-of-the-low-frequency-high-frequency-ratio-of-heart-rate-variability-to-predict-short-term-deterioration-in-emergency-department-patients-with-sepsis
#9
Douglas P Barnaby, Shannon M Fernando, Kevin J Ferrick, Christophe L Herry, Andrew J E Seely, Polly E Bijur, E John Gallagher
OBJECTIVE: To examine the ability of the low-frequency/high-frequency (LF/HF) ratio of heart rate variability (HRV) analysis to identify patients with sepsis at risk of early deterioration. METHODS: This is a prospective observational cohort study of patients with sepsis presenting to the Montefiore Medical Center ED from December 2014 through September 2015. On presentation, a single ECG Holter recording was obtained and analysed to obtain the LF/HF ratio of HRV...
August 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28821491/is-less-more-or-is-it-less-the-growing-evidence-on-high-intensity-hospital-care
#10
Ziad Obermeyer
No abstract text is available yet for this article.
August 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28814480/pharmacy-preceptorship-in-the-emergency-department
#11
LETTER
Marta Miarons
No abstract text is available yet for this article.
August 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28814479/early-prediction-of-hospital-admission-for-emergency-department-patients-a-comparison-between-patients-younger-or-older-than-70-years
#12
Jacinta A Lucke, Jelle de Gelder, Fleur Clarijs, Christian Heringhaus, Anton J M de Craen, Anne J Fogteloo, Gerard J Blauw, Bas de Groot, Simon P Mooijaart
OBJECTIVE: The aim of this study was to develop models that predict hospital admission to ED of patients younger and older than 70 and compare their performance. METHODS: Prediction models were derived in a retrospective observational study of all patients≥18 years old visiting the ED of a university hospital during the first 6 months of 2012. Patients were stratified into two age groups (<70 years old and ≥70 years old). Multivariable logistic regression analysis was used to identify predictors of hospital admission among factors available immediately after patient arrival to the ED...
August 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28814478/effect-of-patient-weight-on-first-pass-success-and-neuromuscular-blocking-agent-dosing-for-rapid-sequence-intubation-in-the-emergency-department
#13
Asad E Patanwala, John C Sakles
OBJECTIVES: The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing. METHODS: This was a retrospective cohort study conducted in a tertiary care academic ED. Consecutive adult patients who underwent RSI in the ED between January 2014 and June 2016 were included...
August 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28801485/identifying-discordance-between-senior-physicians-and-trainees-on-the-root-cause-of-ed-revisits
#14
Michael P Goldman, Michael C Monuteaux, Catherine Perron, Richard G Bachur
OBJECTIVE: Analysis of 72-hour ED revisits is a common emergency medicine quality assurance (QA) practice. Our aim was to compare the perceived root cause for 72-hour ED revisits between senior physicians (attendings) and trainees. We proposed that discordance in perception of why the revisit occurred would guide improvements in 72-hour revisits QA and elucidate innovative educational opportunities. METHODS: Questionnaire-based observational study conducted in an urban academic paediatric ED...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28801484/predicting-outcomes-in-traumatic-out-of-hospital-cardiac-arrest-the-relevance-of-utstein-factors
#15
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: Given low survival rates in cases of traumatic out-of-hospital cardiac arrest (OHCA), there is a need to identify factors associated with outcomes. We aimed to investigate Utstein factors associated with achieving return of spontaneous circulation (ROSC) and survival to hospital in traumatic OHCA. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify cases of traumatic OHCA that received attempted resuscitation and occurred between July 2008 and June 2014...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28801483/characteristics-of-youth-agreeing-to-electronic-sexually-transmitted-infection-risk-assessment-in-the-emergency-department
#16
Fahd A Ahmad, Donna B Jeffe, Katie Plax, Kenneth B Schechtman, Dwight E Doerhoff, Jane M Garbutt, David M Jaffe
OBJECTIVES: Adolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested. METHODS: This was a prospective study conducted in a paediatric ED between April and December 2011...
August 11, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28790144/impact-of-physician-navigators-on-productivity-indicators-in-the-ed
#17
Alexander K Leung, Gaurav Puri, Bingshu E Chen, Zhenxian Gong, Eddie Chan, Edward Feng, Marko Duic
OBJECTIVES: We created Physician Navigators in our ED to help improve emergency physician (EP) productivity. We aimed to quantify the effect of Physician Navigators on measures of EP productivity: patient seen per hour (Pt/hr), and turn-around time (TAT) to discharge. Secondary objectives included examining their impact on measures of ED throughput for non-resuscitative patients: ED length of stay (LOS), door-to-physician time and left-without-being-seen rates (LWBS). METHODS: In this retrospective study, 6845 clinical shifts worked by 20 EPs at a community ED in Newmarket, Canada from 1 January 2012 to 31 March 2015 were evaluated...
August 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28784609/understanding-cardiac-troponin-part-1-avoiding-troponinitis
#18
REVIEW
Richard Body, Edward Carlton
Cardiac troponin (cTn) is a highly specific biomarker of myocardial injury and is central to the diagnosis of acute myocardial infarction (AMI). By itself, however, cTn cannot identify the cause of myocardial injury. 'Troponinitis' is the condition that leads clinicians to falsely assign a diagnosis of AMI based only on the fact that a patient has an elevated cTn concentration. There are many causes of myocardial injury other than AMI. Clinicians are required to differentiate myocardial injury caused by AMI from other causes...
August 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28784608/characteristics-and-occurrence-of-type-2-myocardial-infarction-in-emergency-department-patients-a-prospective-study
#19
Jaimi H Greenslade, Thushani Adikari, Christian Mueller, Yader Sandoval, Thomas Nestelberger, William Parsonage, Tracey Hawkins, Louise Cullen
OBJECTIVE: To identify differences in prevalence, demographics, clinical features and outcomes for type 1 myocardial infarction (T1MI) and type 2 myocardial infarction (T2MI) in a cohort of patients presenting to the Emergency Department (ED) with chest pain. METHODS: This was a post hoc analysis of data collected from two prospective studies. Data were collected between November 2008 and February 2011 for the first study, and between February 2011 and March 2014 for the second...
August 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28784607/extreme-event-medicine-considerations-for-the-organisation-of-out-of-hospital-care-during-obstacle-adventure-and-endurance-competitions
#20
REVIEW
Linda Laskowski-Jones, Michael J Caudell, Seth C Hawkins, Lawrence J Jones, Chelsea A Dymond, Tracy Cushing, Sanjey Gupta, David S Young, Jennifer M Starling, Richard Bounds
Obstacle, adventure and endurance competitions in challenging or remote settings are increasing in popularity. A literature search indicates a dearth of evidence-based research on the organisation of medical care for wilderness competitions. The organisation of medical care for each event is best tailored to specific race components, participant characteristics, geography, risk assessments, legal requirements, and the availability of both local and outside resources. Considering the health risks and logistical complexities inherent in these events, there is a compelling need for guiding principles that bridge the fields of wilderness medicine and sports medicine in providing a framework for the organisation of medical care delivery during wilderness and remote obstacle, adventure and endurance competitions...
August 7, 2017: Emergency Medicine Journal: EMJ
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