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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/28052919/traumatic-brain-injuries-in-older-adults-6-years-of-data-for-one-uk-trauma-centre-retrospective-analysis-of-prospectively-collected-data
#1
Carol Hawley, Magdy Sakr, Sarah Scapinello, Jesse Salvo, Paul Wrenn
OBJECTIVES: Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. METHODS: Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma...
January 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28039232/the-role-of-reduced-heart-rate-volatility-in-predicting-disposition-from-the-emergency-department
#2
Ya-El Mandel-Portnoy, George T Loo, Diana Gregoriou, Sameer Bansilal, Lynne D Richardson
OBJECTIVE: Heart rate volatility (HRVO) is a physiological parameter that is believed to reflect the sympathetic activity of the autonomic nervous system. We explored the utility of HRVO as a predictive tool for declining physiological states, hypothesising that patients admitted from the resuscitation area of the ED to a high-dependency unit (HDU) experience low HRVO compared with patients who did not. METHODS: We retrospectively reviewed HR data recordings, medical charts and disposition decisions from the ED of patients who were admitted to the five resuscitation beds in our adult ED between 29 April 2014 and 30 May 2015...
December 30, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28031242/withdrawal-of-life-sustaining-therapy-the-case-for-delay
#3
EDITORIAL
Bernard A Foëx
No abstract text is available yet for this article.
December 28, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27993937/validity-of-the-manchester-triage-system-in-patients-with-sepsis-presenting-at-the-ed-a-first-assessment
#4
Ingo Gräff, Bernd Goldschmidt, Procula Glien, Ramona C Dolscheid-Pommerich, Rolf Fimmers, Daniel Grigutsch
BACKGROUND: The Manchester Triage System (MTS) does not have a specific presentational flow chart for sepsis. The goal of this investigation was to determine adequacy of acuity assignment for patients with sepsis presenting at the ED and triaged using the MTS. MATERIALS AND METHODS: This retrospective analysis included patients >16 presenting to an ED in Bonn, Germany, on the first 12 days of each month between June 2012 and March 2014. Patients were classified into one of three septic groups, or no sepsis...
December 19, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27993936/mid-arm-circumference-can-be-used-to-estimate-weight-of-adult-and-adolescent-patients
#5
Giles N Cattermole, Colin A Graham, Timothy H Rainer
OBJECTIVES: Many drug and fluid regimens in emergency medicine are weight dependent in adults, but no standard adult weight estimation tools exist. Paediatric weight is often estimated in emergency situations using methods based on age or height when direct measurement is not possible, and recently, methods based on mid-arm circumference (MAC) have also been developed. The aim of this study was to derive and validate an accurate MAC-based method for weight estimation for use in all age groups...
December 19, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27986838/a-randomised-experiment-comparing-low-cost-ultrasound-gel-alternative-with-commercial-gel
#6
Christine Riguzzi, Allison Binkowski, Mike Butterfield, Farhad Sani, Nathan Teismann, Jahan Fahimi
OBJECTIVE: Point-of-care ultrasound is a portable, relatively low-cost imaging modality with great potential utility in low-resource settings. However, commercially produced ultrasound gel is often cost-prohibitive and unavailable. We investigated whether images obtained using an alternative cornstarch-based gel would be of comparable quality with those using commercial gel. METHODS: This was a blinded, randomised, cross-over study comparing commercially produced ultrasound gel with home-made cornstarch-based gel...
December 16, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27920036/clinical-relevance-of-pharmacist-intervention-in-an-emergency-department
#7
Maria Antonia Pérez-Moreno, Juan Manuel Rodríguez-Camacho, Beatriz Calderón-Hernanz, Bernardino Comas-Díaz, Jordi Tarradas-Torras
OBJECTIVES: To evaluate the clinical relevance of pharmacist intervention on patient care in emergencies, to determine the severity of detected errors. Second, to analyse the most frequent types of interventions and type of drugs involved and to evaluate the clinical pharmacist's activity. METHODS: A 6-month observational prospective study of pharmacist intervention in the Emergency Department (ED) at a 400-bed hospital in Spain was performed to record interventions carried out by the clinical pharmacists...
December 5, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27884924/low-acuity-presentations-to-the-emergency-department-in-canada-exploring-the-alternative-attempts-to-avoid-presentation
#8
Lynette D Krebs, Scott W Kirkland, Rajiv Chetram, Taylor Nikel, Britt Voaklander, Alan Davidson, Bryn Holroyd, Cristina Villa-Roel, Katelynn Crick, Stephanie Couperthwaite, Chris Alexiu, Garnet Cummings, Brian H Rowe
OBJECTIVE: ED visits have been rising year on year worldwide. It has been suggested that some of these visits could be avoided if low-acuity patients had better primary care access. This study explored patients' efforts to avoid ED presentation and alternative care sought prior to presentation. METHODS: Consecutive adult patients presenting to three urban EDs in Edmonton, Canada, completed a questionnaire collecting demographics, actions attempted to avoid presentation and reasons for presentation...
November 24, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27884923/clinical-metrics-in-emergency-medicine-the-shock-index-and-the-probability-of-hospital-admission-and-inpatient-mortality
#9
Kamna S Balhara, Yu-Hsiang Hsieh, Bachar Hamade, Ryan Circh, Gabor D Kelen, Jamil D Bayram
STUDY OBJECTIVES: The shock index (SI), defined as the ratio of HR to systolic BP, has been studied as an alternative prognostic tool to traditional vital signs in specific disease states and subgroups of patients. However, literature regarding its utility in the general ED population is lacking. Our main objective was to determine the probability of admission and inpatient mortality based on the first measured SI at initial presentation in the general adult ED population in our tertiary care centre...
November 24, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27884922/letter-to-editor-best-estimations-of-the-effects-of-alcohol-on-emergency-department-attendance
#10
LETTER
Matthew Welch, Hunniya Waseem, Andy Catton, Jon Barratt
No abstract text is available yet for this article.
November 24, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27872143/authors-response-predictors-of-patient-satisfaction-in-an-emergency-care-centre-in-central-saudi-arabia-a-prospective-study
#11
LETTER
Mostafa A Abolfotouh, Mohammed H Al-Assiri, Rabab T Alshahrani, Zainab M Almutairi, Raid A Hijazi, Ahmed S Alaskar
No abstract text is available yet for this article.
November 21, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27852652/chest-compression-fraction-in-ambulance-while-transporting-patients-with-out-of-hospital-cardiac-arrest-to-the-hospital-in-rural-taiwan
#12
Shih-Chang Hung, Ching-Yi Mou, Hung-Chang Hung, I-Hsiang Lin, Shih-Wei Lai, Jack YinChun Huang
INTRODUCTION: Maintaining the standard two-handed chest compression is difficult in high-speed ambulances in rural areas. METHODS: A retrospective, video-based, observational study was conducted from June to September 2013 in Nantou, a rural county of central Taiwan, to evaluate the chest compression fraction in an ambulance carriage during the travel from the scene to the hospital. The chest compression fraction was calculated as the chest compression time period divided by the ambulance travelling time period; the one-handed and two-handed chest compression fractions were also calculated...
November 15, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27852651/emergency-procedures-for-patients-with-a-continuous-flow-left-ventricular-assist-device
#13
Juliane Vierecke, Martin Schweiger, David Feldman, Evgenij Potapov, Friedrich Kaufmann, Lorenzo Germinario, Roland Hetzer, Volkmar Falk, Thomas Krabatsch
The number of ventricular assist devices (VADs) being implanted for terminal heart failure is rising at an exponential rate. These implanted patients have a decreased mortality, but still have significant morbidities, as the prevalence of these patients increases in the community. When VAD patients are discharged to home, they will very likely require emergency medical services (EMSs) and emergency medical doctors (EDs) with their future care. The interface of these patients with the community would suggest an increasing prevalence of encounters requiring the need for acute medical care...
November 15, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27803126/put-pressure-on-the-cricoid-pressure
#14
EDITORIAL
Patrick Schober, Lothar A Schwarte
No abstract text is available yet for this article.
November 1, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27793963/can-emergency-medicine-research-benefit-from-adaptive-design-clinical-trials
#15
Laura Flight, Steven A Julious, Steve Goodacre
BACKGROUND: Adaptive design clinical trials use preplanned interim analyses to determine whether studies should be stopped or modified before recruitment is complete. Emergency medicine trials are well suited to these designs as many have a short time to primary outcome relative to the length of recruitment. We hypothesised that the majority of published emergency medicine trials have the potential to use a simple adaptive trial design. METHODS: We reviewed clinical trials published in three emergency medicine journals between January 2003 and December 2013...
October 28, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27797874/patient-satisfaction-may-need-to-be-weighed-by-patient-acuity-in-the-emergency-department
#16
LETTER
Amir Mirhaghi
No abstract text is available yet for this article.
October 25, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27797873/skin-and-soft-tissue-infection-management-failure-in-the-emergency-department-observation-unit-a-systematic-review
#17
Jeremy W Abetz, Nicholas G Adams, Biswadev Mitra
INTRODUCTION: Skin and soft tissue infections (SSTIs) are commonly treated in ED observation units (EDOUs). The management failure rate in this setting is high, as evidenced by a large proportion of patients requiring inpatient admission. This systematic review sought to quantify the management failure rate and identify risk factors associated with management failure. METHODS: Searches of six databases and grey literature were conducted with no limits on publication year or language...
October 25, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27797872/a-comparison-of-pain-assessment-by-physicians-parents-and-children-in-an-outpatient-setting
#18
Christina Brudvik, Svein-Denis Moutte, Valborg Baste, Tone Morken
INTRODUCTION: Our objective was to compare pain assessments by patients, parents and physicians in children with different medical conditions, and analyse how this affected the physicians' administration of pain relief. PATIENTS AND METHODS: This cross-sectional study involved 243 children aged 3-15 years treated at Bergen Accident and Emergency Department (ED) in 2011. The child patient's pain intensity was measured using age-adapted scales while parents and physicians did independent numeric rating scale (NRS) assessments...
October 25, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27797870/reasons-and-evolution-of-non-thrombolysis-in-acute-ischaemic-stroke
#19
T Reiff, P Michel
INTRODUCTION: Despite increasing evidence of its efficacy in advanced age or in mild or severe strokes, intravenous thrombolysis remains underused for acute ischaemic stroke (AIS). Our aim was to obtain an updated view of reasons for non-thrombolysis and to identify its changing patterns over time. METHODS: This is a retrospective study of prospectively collected data from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) from the years 2003-2011. Patients admitted with acute stroke in the past 24 hours who had not had thrombolysis were identified; reasons for non-thrombolysis documented in the prospectively entered data were tabulated and analysed for the group as a whole...
October 25, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27797871/procedural-sedation-in-the-emergency-department-by-dutch-emergency-physicians-a-prospective-multicentre-observational-study-of-1711-adults
#20
Gaël Jp Smits, Maybritt I Kuypers, Lisette Aa Mignot, Eef Pj Reijners, Erick Oskam, Karen Van Doorn, Wendy Amh Thijssen, Erik Hm Korsten
OBJECTIVE: To describe our experience performing ED procedural sedation in a country where emergency medicine (EM) is a relatively new specialty. METHODS: This is a prospective observational study of adult patients undergoing procedural sedation by emergency physicians (EPs) or EM residents in eight hospitals in the Netherlands. Data were collected on a standardised form, including patient characteristics, sedative and analgesic used, procedural success, adverse events (classified according to World SIVA) and rescue interventions...
October 21, 2016: Emergency Medicine Journal: EMJ
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