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Emergency Medicine Journal: EMJ

Les Gordon, Peter Paal
No abstract text is available yet for this article.
July 7, 2018: Emergency Medicine Journal: EMJ
Mats Warmerdam, Lucia Baris, Margo van Liebergen, Annemieke Ansems, Laura Esteve Cuevas, Merel Willeboer, Douwe Rijpsma, Amith L Shetty, Bas de Groot
OBJECTIVE: In existing risk stratification and resuscitation guidelines for sepsis, a hypotension threshold of systolic blood pressure (SBP) below 90-100 mmHg is typically used. However, for older patients, the clinical relevance of a SBP in a seemingly 'normal' range (>100 mmHg) is still poorly understood, as they may need higher SBP for adequate tissue perfusion due to arterial stiffening. We therefore investigated the association between SBP and mortality in older emergency department (ED) patients hospitalised with a suspected infection...
July 7, 2018: Emergency Medicine Journal: EMJ
Marissa Cohen, Donald Jeanmonod, Holly Stankewicz, Keith Habeeb, Matthew Berrios, Rebecca Jeanmonod
INTRODUCTION: Perceptions regarding body art change over time as societal norms change. Previous research regarding patients' perceptions of physicians with exposed body art have been hampered by flaws in design methodology that incorporate biases into patient responses. This study was performed to determine whether emergency department (ED) patients perceived a difference in physician competence, professionalism, caring, approachability, trustworthiness and reliability in the setting of exposed body art...
July 2, 2018: Emergency Medicine Journal: EMJ
Esther Murray, Charlotte Krahé, Danë Goodsman
BACKGROUND: The term 'moral injury' may be useful in conceptualising the negative psychological effects of delivering emergency and prehospital medicine as it provides a non-pathological framework for understanding these effects. This is in contrast to concepts such as burnout and post-traumatic stress disorder which suggest practitioners have reached a crisis point. We conducted an exploratory, pilot study to determine whether the concept of moral injury resonated with medical students working in emergency medicine and what might mitigate that injury for them...
June 26, 2018: Emergency Medicine Journal: EMJ
Adrian A Boyle, Michael S Martin, Haroon Ahmed, Katrina Snelling, Jonathon Dean, James Price
INTRODUCTION: Violent injury places a large burden on the NHS. We had implemented information sharing in our ED in 2007 and aimed to see which patient groups were most affected by information sharing, as this would provide clues as to how this complex intervention works. METHODS: Retrospective time series study of all the assault victims presenting for ED care between 2005 and 2014 at a single ED in England. RESULTS: 10 328 patients presented during the study period...
June 25, 2018: Emergency Medicine Journal: EMJ
Matthew J Reed, Neil R Grubb, Christopher C Lang, Alasdair J Gray, Kirsty Simpson, Allan MacRaild, Christopher J Weir
OBJECTIVES: Diagnosing underlying arrhythmia in ED syncope patients remains problematic. This study investigates diagnostic yield, event prevalence, patient satisfaction and compliance, and influence on resource utilisation of an ambulatory patch monitor in unexplained ED syncope patients. METHODS: Prospective pilot study conducted in a single tertiary ED in Scotland between 17 November 2015 and 16 June 2017 with a historical unmatched comparator group. Patients 16 years or over presenting within 6 hours of unexplained syncope were fitted in the ED with an ambulatory patch ECG recorder (Zio XT monitor), which continuously records a single-lead ECG for up to 14 days...
June 19, 2018: Emergency Medicine Journal: EMJ
Don Pham, Daniel Addison, Waleed Kayani, Arunima Misra, Hani Jneid, Jon Resar, Nassir Lakkis, Mahboob Alam
OBJECTIVES: Beta blockers (β-blockers) remain a standard therapy in the early treatment of acute coronary syndromes. However, β-blocker therapy in patients with cocaine-associated chest pain (CACP) continues to be an area of debate due to the potential risk of unopposed α-adrenergic stimulation and coronary vasospasm. Therefore, we performed a systematic review and meta-analysis of available studies to compare outcomes of β-blocker versus no β-blocker use among patients with CACP...
June 19, 2018: Emergency Medicine Journal: EMJ
Dawn Dalen, Amy Fry, Samuel G Campbell, Jeffrey Eppler, Peter J Zed
OBJECTIVE: The purpose of our study was to determine if cephalexin 500 mg orally four times daily was non-inferior to cefazolin 2 g intravenously daily plus probenecid 1 g orally daily in the management of patients with uncomplicated mild-moderate skin and soft tissue infection (SSTI) presenting to the ED. METHODS: This was a prospective, multicentre, double dummy-blind, randomised controlled non-inferiority trial conducted at two tertiary care teaching hospitals in Canada...
June 18, 2018: Emergency Medicine Journal: EMJ
Elaine Rabin
No abstract text is available yet for this article.
June 18, 2018: Emergency Medicine Journal: EMJ
Anja Ebker-White, Kendall J Bein, Michael M Dinh
OBJECTIVE: This study aims to validate previously reported triage tool titled Sydney Triage to Admission Risk Tool (START+) and investigate whether an extended version of the tool could be used to identify and stream appropriate short stay admissions to ED observation units or specialised short stay inpatient wards. METHODS: This was a prospective study at two metropolitan EDs in Sydney, Australia. Consecutive triage encounters were observed by a trained researcher and START scores calculated...
June 18, 2018: Emergency Medicine Journal: EMJ
Stephen Hearns
No abstract text is available yet for this article.
June 15, 2018: Emergency Medicine Journal: EMJ
Andrew Loftus, Harvey Pynn, Paul Parker
Terrorist acts occur every day around the world. Healthcare professionals are often present as bystander survivors in these situations, with none of the equipment or infrastructure they rely on in their day-to-day practice. Within several countries there has been a move to disseminate the actions to take in the event of such attacks: in the UK, Run, Hide, Tell , and in the USA, Fight Back This paper outlines how a very basic medical knowledge combined with everyday high-street items can render highly effective first aid and save lives...
June 15, 2018: Emergency Medicine Journal: EMJ
Jacky Hanson, Kirsten Walthall
No abstract text is available yet for this article.
June 9, 2018: Emergency Medicine Journal: EMJ
Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Yohei Okada, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Makoto Watanabe, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura, Bon Ohta
BACKGROUND: Accidental hypothermia (AH) has higher incidence and mortality in geriatric populations. Japan has a rapidly ageing population, and little is known about the epidemiology of hypothermia in this country. METHODS: We created an AH registry based on retrospective review of patients visiting the ED of 12 institutions with temperature ≤35°C between April 2011 and March 2016. The severity of AH was classified as mild (≤35, ≥32°C), moderate (<32, ≥28°C) or severe (<28°C)...
June 9, 2018: Emergency Medicine Journal: EMJ
Amit Lehavi, Avraham Yitzhak, Refael Jarassy, Rami Heizler, Yeshayahu Shai Katz, Aeyal Raz
OBJECTIVES: Warming intravenous fluids is essential to prevent hypothermia in patients with trauma, especially when large volumes are administered. Prehospital and transport settings require fluid warmers to be small, energy efficient and independent of external power supply. We compared the warming properties and resistance to flow of currently available battery-operated fluid warmers. METHODS: Fluid warming was evaluated at 50, 100 and 200 mL/min at a constant input temperature of 20°C and 10°C using a cardiopulmonary bypass roller pump and cooler...
June 7, 2018: Emergency Medicine Journal: EMJ
(no author information available yet)
No abstract text is available yet for this article.
June 6, 2018: Emergency Medicine Journal: EMJ
Annemieke E Boendermaker, Constant W Coolsma, Marloes Emous, Ewoud Ter Avest
INTRODUCTION: Many patients presenting with abdominal pain to emergency departments (EDs) are discharged without a definitive diagnosis. For these patients, often designated as having non-specific abdominal pain, re-evaluation is often advocated. We aimed to investigate how often re-evaluation changes the diagnosis and clinical management and discern factors that could help identify patients likely to benefit from re-evaluation. METHODS: This was a retrospective study conducted in the Netherlands between 1 January 2014 and 31 December 2015 of patients asked to return to the ED after an initial presentation with acute non-traumatic abdominal pain...
June 2, 2018: Emergency Medicine Journal: EMJ
Tim Harris, Timothy J Coats, Mohammed H Elwan
Intravenous fluid therapy is one of the most common therapeutic interventions performed in the ED and is a long-established treatment. The potential benefits of fluid therapy were initially described by Dr W B O'Shaughnessy in 1831 and first administered to an elderly woman with cholera by Dr Thomas Latta in 1832, with a marked initial clinical response. However, it was not until the end of the 19th century that medicine had gained understanding of infection risk that practice became safer and that the practice gained acceptance...
May 28, 2018: Emergency Medicine Journal: EMJ
Mark R Burgess, Kate Crewdson, David J Lockey, Zane B Perkins
INTRODUCTION: Prehospital emergency anaesthesia (PHEA or 'prehospital rapid sequence intubation') is a high-risk procedure. Standard operating procedures (SOPs) and checklists within healthcare systems have been demonstrated to reduce human error and improve patient safety. We aimed to describe the current practice of PHEA in the UK, determine the use of checklists for PHEA and describe the content, format and layout of any such checklists currently used in the UK. METHOD: A survey of UK prehospital teams was conducted to establish the incidence and conduct of PHEA practice...
May 24, 2018: Emergency Medicine Journal: EMJ
(no author information available yet)
No abstract text is available yet for this article.
May 21, 2018: Emergency Medicine Journal: EMJ
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