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European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine

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https://www.readbyqxmd.com/read/30431450/validation-of-the-short-form-of-the-international-crowding-measure-in-emergency-departments-an-international-study
#1
Adrian Boyle, Paul Atkinson, Carlos Basaure Verdejo, Edward Chan, Robin Clouston, Paedar Gilligan, Karan Grewal, Ian Higginson, Paul Liston, Virginia Newcombe, Valerie Norton, Sophie Richter, George Stoica, Abel Wakai
OBJECTIVE: There is little consensus on the best way to measure emergency department (ED) crowding. We have previously developed a consensus-based measure, the International Crowding Measure in Emergency Departments. We aimed to externally validate a short form of the International Crowding Measure in Emergency Department (sICMED) against emergency physician's perceptions of crowding and danger. METHODS: We performed an observational validation study in seven EDs in five different countries...
November 13, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30422928/envenomation-by-the-common-european-adder-vipera-berus-a-case-series-of-219-patients
#2
Mette N Hermansen, Andrea H Krug, Eirik Tjønnfjord, Mikkel Brabrand
OBJECTIVES: Every year, several patients are bitten by the common European adder (Vipera berus). The aim of this study is to present a large consecutive case series of patients bitten by V. berus, and to identify signs and symptoms indicative of complicated illness. PATIENTS AND METHODS: This is a retrospective case series from the Hospital of South West Jutland, Denmark. All 219 patients bitten by V. berus (diagnosed by history or clinical findings) from 1994 to 2012 were identified through hospital databases...
November 12, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30362973/end-tidal-carbon-dioxide-monitoring-in-acute-asthma-a-prospective-pilot-study-in-emergency-department-patients
#3
Jennifer Truchot, Albéric-Rembrandt Gayet, Anne-Laure Philippon, Anthony Chauvin, Johanna Malka, Eric Vicaut, Patrick Plaisance
BACKGROUND: The peak expiratory flow rate (PEFR) is the gold standard for monitoring asthmatic patients. However, its measurement requires understanding and active participation. End tidal carbon dioxide (EtCO2) may be considered an accurate surrogate for PaCO2, a severity marker in acute asthma. We studied the use of EtCO2 as a monitoring tool in acute asthma. PATIENTS AND METHODS: This was a prospective study that included consecutive patients admitted to our emergency department for acute asthma exacerbation...
October 22, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30308574/evaluation-of-the-discriminative-performance-of-the-prehospital-national-advisory-committee-for-aeronautics-score-regarding-48-h-mortality
#4
Vincent Darioli, Patrick Taffé, Pierre-Nicolas Carron, Fabrice Dami, Laurent Vallotton, Bertrand Yersin, Patrick Schoettker, Mathieu Pasquier
OBJECTIVE: The National Advisory Committee for Aeronautics (NACA) score is used by many emergency medical services to assess the severity of prehospital patients. Little is known about its discriminative performance regarding short-term mortality. PARTICIPANTS AND METHODS: We retrospectively included adult missions between 2008 and 2014 in a Swiss ground and air-based emergency medical services. We excluded uninjured or dead-on-scene patients. Primary outcome was assessment of the discriminative performance of the NACA score to classify the 48-h vital status of patients...
October 10, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30289775/enhanced-triage-for-patients-with-suspected-cardiac-chest-pain-the-history-and-electrocardiogram-only-manchester-acute-coronary-syndromes-he-macs-decision-aid
#5
Abdulrhman Alghamdi, Laura Howard, Charles Reynard, Philip Moss, Heather Jarman, Kevin Mackway-Jones, Simon Carley, Richard Body
OBJECTIVES: Several decision aids can 'rule in' and 'rule out' acute coronary syndromes (ACS) in the Emergency Department (ED) but all require measurement of blood biomarkers. A decision aid that does not require biomarker measurement could enhance risk stratification at triage and could be used in the prehospital environment. We aimed to derive and validate the History and ECG-only Manchester ACS (HE-MACS) decision aid using only the history, physical examination and ECG. METHODS: We undertook secondary analyses in three prospective diagnostic accuracy studies that included patients presenting to the ED with suspected cardiac chest pain...
October 4, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30273210/reply-to-lung-ultrasound-for-the-diagnosis-of-pneumonia
#6
Daniele Orso, Nicola Guglielmo, Roberto Copetti
No abstract text is available yet for this article.
September 29, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30234557/can-epinephrine-therapy-be-detrimental-to-patients-with-hypertrophic-cardiomyopathy-with-hypotension-or-cardiac-arrest-a-systematic-review
#7
Jonathan Ilicki, Samuel Bruchfeld, Therese Djärv
Approximately 10% of sudden cardiac deaths among patients under 35 years of age is owing to hypertrophic cardiomyopathy (HCM)-related cardiac arrest (CA). CA is often associated with pre-arrest or peri-arrest hypotension and is treated by a set of interventions, including the administration of epinephrine. It is debated whether epinephrine increases or decreases survival to discharge following CA. HCM is associated with septal hypertrophy with a dynamic left ventricular outflow tract obstruction and impaired peripheral vasoconstriction in response to α1-adrenergic stimulation, both of which could cause epinephrine to have a different effect than in the general population...
September 18, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30179895/trend-analysis-of-emergency-department-malpractice-claims-in-the-netherlands-a-retrospective-cohort-analysis
#8
Luuk Wansink, Maybritt I Kuypers, Tom Boeije, Crispijn L van den Brand, Manon de Waal, Joris Holkenborg, Ewoud Ter Avest
BACKGROUND: Over the past two decades, several quality improvement projects have been implemented in emergency departments (EDs) in the Netherlands, one of these being the training and deployment of emergency physicians. In this study we aim to perform a trend analysis of ED quality of care in Dutch hospitals, as measured by the incidence of medical malpractice claims. PATIENTS AND METHODS: We performed a multicentre retrospective cohort study of malpractice claims in five Dutch EDs over the period 1998-2014...
September 1, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30169464/epidemiology-of-patients-presenting-with-dyspnea-to-emergency-departments-in-europe-and-the-asia-pacific-region
#9
Said Laribi, Gerben Keijzers, Oene van Meer, Sharon Klim, Justina Motiejunaite, Win Sen Kuan, Richard Body, Peter Jones, Mehmet Karamercan, Simon Craig, Veli-Pekka Harjola, Anna Holdgate, Adela Golea, Colin Graham, Franck Verschuren, Jean Capsec, Michael Christ, Leslie Grammatico-Guillon, Cinzia Barletta, Luis Garcia-Castrillo, Anne-Maree Kelly
OBJECTIVE: The primary objective of this study was to describe the epidemiology and management of dyspneic patients presenting to emergency departments (EDs) in an international patient population. Our secondary objective was to compare the EURODEM and AANZDEM patient populations. PATIENTS AND METHODS: An observational prospective cohort study was carried out in Europe and the Asia-Pacific region. The study included consecutive patients presenting to EDs with dyspnea as the main complaint...
August 30, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30138252/prognostic-value-of-prehospital-quick-sequential-organ-failure-assessment-score-among-patients-with-suspected-infection
#10
Prabakar Vaittinada Ayar, Mathieu Delay, Aurélie Avondo, François-Xavier Duchateau, Pierre Nadiras, Frédéric Lapostolle, Tahar Chouihed, Yonathan Freund
OBJECTIVE: After the third international consensus on sepsis released its new definitions, the prognostic value of quick sequential organ failure assessment (qSOFA) score has been confirmed in the emergency department. However, its validity in the prehospital setting remains unknown. The objective of the study was to assess its accuracy for prehospital patients cared by emergency physician-staffed ambulances (services mobiles d'urgence et de réanimation SMUR). PATIENTS AND METHODS: This was a prospective observational multicenter cohort study (N=6)...
August 22, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30379717/can-emergency-physicians-accurately-interpret-computed-tomography-scans-performed-for-suspected-nontraumatic-subarachnoid-haemorrhage-a-cross-sectional-study
#11
LETTER
Richard Austin, James Price, Adrian Boyle
No abstract text is available yet for this article.
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30379716/prehospital-emergency-care-systems-in-europe-eusem-prehospital-section-survey-2016
#12
Jana Seblova, Diana Cimpoesu, Abdo Khoury, Eric Revue, Stefan Trenkler
No abstract text is available yet for this article.
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30379715/burnout-and-satisfaction-among-young-emergency-physicians
#13
LETTER
Jennifer Truchot, Anthony Chauvin, Alice Hutin, Thomas Leredu, Patrick Plaisance, Youri Yordanov
No abstract text is available yet for this article.
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30379714/reflections-on-2018
#14
Colin A Graham
No abstract text is available yet for this article.
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30239348/ventricular-fibrillation-recorded-and-analysed-within-an-area-the-size-of-a-mobile-phone-could-it-enable-cardiac-arrest-recognition
#15
Sakari Syväoja, Tuomas T Rissanen, Pamela Hiltunen, Maaret Castren, Pirjo Mäntylä, Antti Kivelä, Ari Uusaro, Helena Jäntti
BACKGROUND: Recognition of out-of-hospital-cardiac arrests (OHCAs) at emergency medical communication centres is based on questions of OHCA symptoms, resulting in 50-80% accuracy rates. However, OHCAs might be recognized more promptly using 'rhythm-based' recognition, whereby a victim's cardiac rhythm is recorded with mobile phone technology that analyses and transmits recordings to emergency medical communication centres for further interpretation. OBJECTIVE: To examine whether the quality of normal cardiac rhythm and the rhythm with the best prognosis in OHCA, ventricular fibrillation (VF), is sufficient for 'rhythm-based' OHCA recognition when recorded within a mobile phone-sized device...
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29462053/vitamin-k-antagonists-and-emergencies
#16
Frédéric Lapostolle, Virginie Siguret, Anne-Céline Martin, Claire Pailleret, Bernard Vigué, Yves Zerbib, Karim Tazarourte
The recent emergence of 'non-VKA' oral anticoagulants may have led to some forgetting that vitamin K antagonists (VKA) are by far the most widely prescribed oral anticoagulants worldwide. Consequently, we decided to summarize the information available on them. This paper presents the problems facing emergency physicians confronted with patients on VKAs in 10 points, from pharmacological data to emergency management. Vitamin K antagonists remain preferable in many situations including in the elderly, in patients with extreme body weights, severe chronic kidney or liver disease or valvular heart disease, and in patients taking VKAs with well-controlled international normalized ratios (INRs)...
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29215380/applying-the-ottawa-subarachnoid-haemorrhage-rule-on-a-cohort-of-emergency-department-patients-with-headache
#17
Kevin H Chu, Gerben Keijzers, Jeremy S Furyk, Robert M Eley, Frances B Kinnear, Ogilvie N Thom, Tegwen E Howell, Ibrahim Mahmoud, Joseph Y S Ting, Anthony F T Brown
OBJECTIVE: The Ottawa subarachnoid haemorrhage (SAH) rule suggests that alert patients older than 15 years with a severe nontraumatic headache reaching maximum intensity within 1 h and absence of high-risk variables effectively have a SAH ruled out. We aimed to determine the proportion of emergency department (ED) patients with any headache fulfilling the entry criteria for the Ottawa SAH rule. PATIENTS AND METHODS: The Ottawa SAH rule was applied retrospectively in a substudy of a prospective snapshot of 34 EDs in Queensland, Australia, carried out over 4 weeks in September 2014...
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28727580/increase-in-intracranial-pressure-by-application-of-a-rigid-cervical-collar-a-pilot-study-in-healthy-volunteers
#18
Iscander M Maissan, Rein Ketelaars, Boris Vlottes, Sanne E Hoeks, Dennis den Hartog, Robert J Stolker
OBJECTIVES: Rigid cervical collars are known to increase intracranial pressure (ICP) in severe traumatic brain injury (TBI). Cerebral blood flow might decrease according to the Kellie Monroe doctrine. For this reason, the use of the collar in patients with severe TBI has been abandoned from several trauma protocols in the Netherlands. There is no evidence on the effect of a rigid collar on ICP in patients with mild or moderate TBI or indeed patients with no TBI. As a first step we tested the effect in healthy volunteers with normal ICPs and intact autoregulation of the brain...
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#19
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28704270/impact-of-ramadan-on-emergency-department-visits-and-on-medical-emergencies
#20
Reem G Al Assaad, Rana Bachir, Mazen J El Sayed
BACKGROUND: Fasting during Ramadan is important to Muslims. This study describes changes in emergency department (ED) visits and in frequencies of emergency conditions and impact on clinical outcomes during Ramadan in a tertiary care center in Beirut, Lebanon. PATIENTS AND METHODS: Patients presenting to ED during Ramadan 1 month before and 1 month after Ramadan over a 3-year period with specific conditions (acute coronary syndrome, stroke, seizure, diabetes, renal colic, headache or hypertension) were included...
December 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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