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Emergency Medicine Journal: EMJ

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https://www.readbyqxmd.com/read/28522436/prognosis-of-undiagnosed-chest-pain-do-emergency-physicians-need-to-rethink-current-practice
#1
Edward Carlton
No abstract text is available yet for this article.
May 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28515132/inclusion-of-emergency-department-patients-in-early-stages-of-sepsis-in-a-quality-improvement-programme-has-the-potential-to-improve-survival-a-prospective-dual-centre-study
#2
Bas De Groot, Bastiaan Struyk, Rashed Najafi, Nieke Halma, Loekie Pelser, Denise Vorst, Bart Mertens, Annemieke Ansems, Douwe Rijpsma
STUDY OBJECTIVE: Sepsis quality improvement programmes typically focus on severe sepsis (ie, with acute organ failure). However, quality of ED care might be improved if these programmes included patients whose progression to severe sepsis could still be prevented (ie, infection without acute organ failure). We compared the impact on mortality of implementing a quality improvement programme among ED patients with a suspected infection with or without acute organ failure. METHODS: This prospective observational study among ED patients hospitalised with suspected infection was conducted in two hospitals in the Netherlands...
May 17, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28501816/emergency-medicine-pharmacists-on-an-international-scale
#3
EDITORIAL
Zlatan Coralic, Bryan D Hayes
No abstract text is available yet for this article.
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28501815/can-the-prehospital-national-early-warning-score-identify-patients-most-at-risk-from-subsequent-deterioration
#4
Joanna Shaw, Rachael T Fothergill, Sophie Clark, Fionna Moore
INTRODUCTION: The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition. METHODS: Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital...
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500089/an-exploration-of-patients-experiences-of-participation-in-a-randomised-controlled-trial-of-the-manchester-acute-coronary-syndromes-macs-decision-rule
#5
Patricia van den Berg, Sarah Kendal, Helen V Alderson, Richard Body
BACKGROUND: As an important part of a pilot study to determine the feasibility of a large randomised controlled trial (RCT) comparing use of the Manchester Acute Coronary Syndromes (MACS) decision rule with standard care, we aimed to explore patient attitudes and potential barriers to participation in a trial of this nature. METHODS: We conducted a qualitative study nested within a pilot RCT comparing use of the MACS rule (which could enable some patients with chest pain to be discharged earlier) with standard care...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500088/spotting-the-black-swan-why-emergency-medicine-is-ahead-of-the-curve
#6
EDITORIAL
Damian Roland
"Black Swans", originally described as an economic theory, are unexpected events whose potential to occur only becomes apparent after they have happened. The concept is very relevant to the practice of Emergency Medicine and this article explores how black swans impact on emergency care and how staff unconsciously aim to mitigate against them.
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500087/feasibility-of-the-manchester-acute-coronary-syndromes-macs-decision-rule-to-safely-reduce-unnecessary-hospital-admissions-a-pilot-randomised-controlled-trial
#7
Richard Body, Charles Boachie, Alex McConnachie, Simon Carley, Patricia Van Den Berg, Fiona E Lecky
BACKGROUND: Observational studies suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule can effectively 'rule out' and 'rule in' acute coronary syndromes (ACS) following a single blood test. In a pilot randomised controlled trial, we aimed to determine whether a large trial is feasible. METHODS: Patients presenting to two EDs with suspected cardiac chest pain were randomised to receive care guided by the MACS decision rule (intervention group) or standard care (controls)...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28500086/detection-of-pneumothoraces-in-patients-with-multiple-blunt-trauma-use-and-limitations-of-efast
#8
Thomas C Sauter, Simon Hoess, Beat Lehmann, Aristomenis K Exadaktylos, Dominik G Haider
BACKGROUND: Extended focused assessment with sonography for trauma (eFAST) has been shown to have moderate sensitivity for detection of pneumothorax in trauma. Little is known about the location or size of missed pneumothoraces or clinical predictors of pneumothoraces in patients with false-negative eFAST. METHODS: This retrospective cross-sectional study includes all patients with multiple blunt trauma diagnosed with pneumothorax who underwent both eFAST and CT performed in the ED of a level 1 trauma centre in Switzerland between 1 June 2012 and 30 September 2014...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#9
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28487288/primary-care-services-co-located-with-emergency-departments-across-a-uk-region-early-views-on-their-development
#10
Suzanne Ablard, Colin O'Keeffe, Shammi Ramlakhan, Suzanne M Mason
BACKGROUND: Co-location of primary care services with Emergency Departments (ED) is one initiative aiming to reduce the burden on EDs of patients attending with non-urgent problems. However, the extent to which these services are operating within or alongside EDs is not currently known.This study aimed to create a typology of co-located primary care services in operation across Yorkshire and Humber (Y&H) as well as identify early barriers and facilitators to their implementation and sustainability...
May 9, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28483932/-major-trauma-now-two-separate-diseases
#11
EDITORIAL
Timothy J Coats, Fiona Lecky
No abstract text is available yet for this article.
May 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28483931/alcohol-identification-and-intervention-in-english-emergency-departments
#12
Robert Patton, Ghiselle Green
AIMS: In the ED, alcohol identification and brief advice is an effective method of reducing consumption and related harms. Our objective was to conduct a national survey of English EDs to determine current practice regarding alcohol identification and provision of brief advice and to compare changes in activity to a previous National Survey conducted in 2011. METHODS: This was a cross-sectional survey of all consultant-led EDs in England. RESULTS: Of 180 departments, 147 (81...
May 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28476730/mountain-rescue-cardiopulmonary-resuscitation-a-comparison-between-manual-and-mechanical-chest-compressions-during-manikin-cardio-resuscitation
#13
Oyvind Thomassen, Sven Christjar Skaiaa, Jorg Assmuss, Øyvind Østerås, Jon Kenneth Heltne, Lars Wik, Guttorm Brattebo
AIM: Chest compression devices are useful during mountain rescue but may cause a delay in transport if not immediately available. The aims of this prospective observational study were to compare manual and mechanical cardiopulmonary resuscitation (CPR) during transport on a sledge connected to a snowmobile with a non-moving setting and to compare CPR quality between manual and two mechanical chest compression devices. METHODS: Sixteen healthcare providers simulated four different combined CPR scenarios on a sledge in a non-moving setting and during transport and two mechanical chest compression devices during transport on the sledge...
May 5, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28473529/an-emergency-medicine-research-priority-setting-partnership-to-establish-the-top-10-research-priorities-in-emergency-medicine
#14
EDITORIAL
Jason Smith, Liza Keating, Lynsey Flowerdew, Rachel O'Brien, Sam McIntyre, Richard Morley, Simon Carley
Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed.
May 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28473528/getting-our-priorities-right-in-emergency-medicine
#15
EDITORIAL
Jonathan Benger
No abstract text is available yet for this article.
May 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28473527/satisfaction-burnout-and-intention-to-stay-of-emergency-nurses-in-shanghai
#16
Hui Jiang, Lily Ma, Caiping Gao, Tengteng Li, Lihua Huang, Weiqin Huang
BACKGROUND: Stability of the nursing workforce is considered a key factor for high-quality healthcare. Satisfaction and burnout are reported to be closely related to staff turnover. This study investigates satisfaction and burnout of ED nurses in Shanghai and association of these factors with intention to stay on the job. METHODS: This is a cross-sectional descriptive survey study conducted between October and December 2015. Our own questionnaire and the Maslach Burnout Inventory were used to construct the survey...
May 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28465319/association-of-magnetic-resonance-imaging-for-back-pain-on-seven-day-return-visit-to-the-emergency-department
#17
Emily L Aaronson, Brian Yun, Elizabeth Mort, David Brown, Ali S Raja, Haytham M A Kaafarani, Yuchiao Chang, Jarone Lee
BACKGROUND: The prevalence of back pain is rising, as is the use of high-cost imaging in the ED. The objective of our study was to determine if an MRI in the ED for patients with back pain resulted in a lower incidence of ED return visit and to determine if these patients had longer ED length of stay (LOS) and use of ED observation. METHODS: A retrospective cohort study of consecutive patients seen with back pain was conducted at an urban, university-affiliated ED between 1 January 2012 and 11 July 2014...
May 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28465318/the-key-to-resilient-individuals-is-to-build-resilient-and-adaptive-systems
#18
EDITORIAL
Liz Crowe, Jeanine Young, Jane Turner
No abstract text is available yet for this article.
May 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28438987/major-trauma-from-suspected-child-abuse-a-profile-of-the-patient-pathway
#19
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
#20
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
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