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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/28438987/major-trauma-from-suspected-child-abuse-a-profile-of-the-patient-pathway
#1
Ffion C Davies, Fiona E Lecky, Ross Fisher, Marisol Fragoso-Iiguez, Tim J Coats
BACKGROUND: Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. METHODS: The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI...
April 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28420689/-the-year-of-first-aid-effectiveness-of-a-3-day-first-aid-programme-for-7-14-year-old-primary-school-children
#2
Balint Banfai, Emese Pek, Attila Pandur, Henrietta Csonka, Jozsef Betlehem
AIM OF THE STUDY: Bystanders can play an important role in the event of sudden injury or illness. Our aim was to evaluate the effects of a 3-day first aid course for all primary school age groups (7-14 years old). METHODS: 582 school children were involved in the study. Training consisted of three sessions with transfer of theoretical knowledge and practical skills about first aid. The following most urgent situations were addressed in our study: adult basic life support (BLS), using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance...
April 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28420688/can-a-partnership-between-general-practitioners-and-ambulance-services-reduce-conveyance-to-emergency-care
#3
Manuel Villarreal, Jonathan Leach, Kandala Ngianga-Bakwin, Jeremy Dale
BACKGROUND: Emergency services are facing increasing workload pressures, and new models of care are needed. We evaluate the impact of a service development involving a partnership between emergency ambulance crews and general practitioners (GPs) on reducing conveyance rates to the Hospital Emergency Department (ED). METHODS: The service model was implemented in the West Midlands of England. Call handlers identified patients with needs that could be addressed by a GP using locally agreed criteria...
April 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28416582/relationship-between-oxygen-concentration-and-temperature-in-an-exothermic-warming-device
#4
Ben Brooks, Charles D Deakin
INTRODUCTION: Actively warming hypothermic patients or preventing hypothermia is critical in optimising outcomes in patients with traumatic injuries. Our aim was to investigate the effect of ambient oxygen concentration on the rate and change in temperature of the TechTrade Ready-Heat II exothermic (oxygen-activated) warming blanket, to evaluate safety and ascertain the risk of thermal injury. METHODS: A mannequin covered with an exothermic blanket was placed in a sealed oxygen tent...
April 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28363994/validating-the-manchester-acute-coronary-syndromes-macs-and-troponin-only-manchester-acute-coronary-syndromes-t-macs-rules-for-the-prediction-of-acute-myocardial-infarction-in-patients-presenting-to-the-emergency-department-with-chest-pain
#5
Jaimi H Greenslade, Robert Nayer, William Parsonage, Shaela Doig, Joanna Young, John W Pickering, Martin Than, Christopher Hammett, Louise Cullen
BACKGROUND: The Manchester Acute Coronary Syndromes (MACS) rule and the Troponin-only MACS (T-MACS) rule risk stratify patients with suspected acute coronary syndrome (ACS). This observational study sought to validate and compare the MACS and T-MACS rules for assessment of acute myocardial infarction (AMI). METHODS: Prospectively collected data from twoEDs in Australia and New Zealand were analysed. Patients were assigned a probability of ACS based on the MACS and T-MACS rules, incorporating high-sensitivity troponin T, heart-type fatty acid-binding protein, ECG results and clinical symptoms...
March 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28356388/emergency-medicine-what-keeps-me-what-might-lose-me-a-narrative-study-of-consultant-views-in-wales
#6
Ffion James, Frances Gerrard
EDs are currently under intense pressure due to increased patient demand. There are major issues with retention of senior personnel, making the specialty a less attractive choice for junior doctors. This study aims to explore what attracted EM consultants to their career and keeps them there. It is hoped this can inform recruitment strategies to increase the popularity of EM to medical students and junior doctors, many of whom have very limited EM exposure. METHODS: Semistructured interviews were conducted with 10 consultants from Welsh EDs using a narrative approach...
March 29, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28341682/the-royal-college-of-emergency-medicine-composite-pain-scale-for-children-level-of-inter-rater-agreement
#7
Ffion James, Rosie Edwards, Nirmal James, Rhian Dyer, Victoria Goodwin
OBJECTIVE: To assess the inter-rater agreement of the Royal College of Emergency Medicine (RCEM) Composite Pain Scale. METHODS: A prospective, observational study of 117 children who presented to the ED with pain due to a limb injury. Pain severity was assessed by the triage nurse, doctor and child (depending on their age) using indicators of the RCEM Composite Pain Scale. This pain scale comprises a modified Wong-Baker FACES Pain Rating Scale (FACES Scale), a Behaviour scale and a numerical rating scale (Ladder)...
March 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28302644/what-is-an-roc-curve
#8
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
#9
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
#10
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
#11
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/28259845/extracorporeal-cardiopulmonary-resuscitation-probably-good-but-adoption-should-not-be-too-fast-and-furious
#12
EDITORIAL
Clifton W Callaway, 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
#13
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
#14
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
#15
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
#16
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/28188203/emergency-department-syndromic-surveillance-to-investigate-the-health-impact-and-factors-associated-with-alcohol-intoxication-in-reunion-island
#17
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
#18
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
#19
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
#20
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
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