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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/29768299/early-variation-of-quick-sequential-organ-failure-assessment-score-to-predict-in-hospital-mortality-in-emergency-department-patients-with-suspected-infection
#1
Lemachatti Najla, Ortega Mar, Penaloza Andrea, Pierrick Le Borgne, Pierre-Géraud Claret, Céline Occelli, Jennifer Truchot, Florence Dumas, Anne-Laure Feral-Pierssens, Héry Andrianjafy, Sebastien Beaune, Youri Yordanov, Pierre Hausfater, Bruno Riou, Ben Bloom, Evguenia Krastinova, Yonathan Freund
BACKGROUND: The quick sequential organ failure assessment (qSOFA) score showed good prognostic performance in patients with suspicion of infection in the emergency department (ED). However, previous studies only assessed the performance of individual values of qSOFA during the ED stay. As this score may vary over short timeframes, the optimal time of measurement, and the prognostic value of its variation are unclear. The objective of the present study was to prospectively assess the prognostic value of the change in qSOFA over the first 3 h (ΔqSOFA=qSOFA at 3 h-qSOFA at inclusion)...
May 15, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29727304/the-frequency-characteristics-and-aetiology-of-stroke-mimic-presentations-a-narrative-review
#2
Graham McClelland, Helen Rodgers, Darren Flynn, Christopher I Price
A significant proportion of patients with acute stroke symptoms have an alternative 'mimic' diagnosis. A narrative review was carried out to explore the frequency, characteristics and aetiology of stroke mimics. Prehospital and thrombolysis-treated patients were described separately. Overall, 9972 studies were identified from the initial search and 79 studies were included with a median stroke mimic rate of 19% (range: 1-64%). The prehospital median was 27% (range: 4-43%) and the thrombolysis median 10% (range: 1-25%)...
May 1, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29621018/management-of-anaphylaxis-in-spain-pediatric-emergency-care-providers-knowledge
#3
Mikel Olabarri, Sebastiá Gonzalez-Peris, Paula Vázquez, Aranzazu González-Posada, Nuria Sanz, Ana Vinuesa, Nuria Diez, Javier Benito, Santiago Mintegi
BACKGROUND: Acute care providers must diagnose and treat patients with anaphylaxis. The objective was to analyze Spanish pediatric emergency departments' (ED) providers' knowledge of the international recommendations for the management of anaphylaxis. METHODS: A web-based survey including providers (both attending and residents) from seven Spanish pediatric EDs was conducted. To analyze the knowledge of the identification of anaphylaxis, we used the diagnostic criteria given by the National Institute of Allergy and Infectious Disease and Food Allergy and the Food Allergy and Anaphylaxis Network (2005)...
April 4, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29465466/the-prevalence-of-unexplained-falls-and-syncope-in-older-adults-presenting-to-an-irish-urban-emergency-department
#4
Jaspreet Bhangu, Patricia Hall, Naomi Devaney, Kathleen Bennett, Laura Carroll, Rose-Anne Kenny, C Geraldine McMahon
AIM: There is growing evidence of an overlap between unexplained falls and syncope in older adults. Our aim was to examine the prevalence and associated resource utilization of these conditions in an urban emergency department (ED). PATIENTS AND METHODS: A single-centre, prospective, observational study was carried out over a 6-month period. Consecutive patients older than 50 years who presented to the ED because of a fall, collapse or syncope were included. Univariate analysis of demographic data is presented as percentages, mean (SD), 95% confidence intervals (CIs) and medians (interquartile range)...
February 20, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29683883/an-evaluation-of-patient-ownership-and-use-and-acceptability-of-smartphone-technology-within-the-emergency-department
#5
LETTER
Alasdair M Summers, Matthew J Reed
No abstract text is available yet for this article.
June 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29683882/changing-directions-for-emergency-medicine-in-2018-from-the-beast-from-the-east-to-the-best-in-the-west
#6
Colin A Graham
No abstract text is available yet for this article.
June 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29481372/ethical-and-scientific-misconduct-the-beginner-s-experience
#7
EDITORIAL
Yonathan Freund
No abstract text is available yet for this article.
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28338532/is-severe-hypercalcemia-immediately-life-threatening
#8
Camille Guimard, Eric Batard, Frédéric Lavainne, David Trewick
OBJECTIVE: Severe hypercalcemia is often considered an emergency because of a potential risk of cardiac arrest or coma. However, there is little evidence to support this. The aim of our study was to assess whether severe hypercalcemia (Ca>4 mmol/l or 16 mg/dl) was associated with immediately life-threatening cardiac arrhythmias or neurological complications in patients admitted to the Emergency Department (ED). METHODS: A retrospective observational study was carried out over a 5-year period (2008-2012)...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27926537/lactate-arterial-and-venous-agreement-in-sepsis-a-prospective-observational-study
#9
Deepankar Datta, Julia Grahamslaw, Alasdair J Gray, Catriona Graham, Craig A Walker
BACKGROUND: Sepsis is a common condition in the emergency department (ED). Lactate measurement is an important part of management: arterial lactate (A-LACT) measurement is the gold standard. There is increasing use of peripheral venous lactate (PV-LACT); however, there is little research supporting the interchangeability of the two measures.If PV-LACT has good agreement with A-LACT, it would significantly reduce patient discomfort and the risks of arterial sampling for a large group of acutely unwell patients, while allowing faster and wider screening, with potential reduced costs to the healthcare system...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27893526/effect-of-oxygen-therapy-on-myocardial-salvage-in-st-elevation-myocardial-infarction-the-randomized-soccer-trial
#10
Ardavan Khoshnood, Marcus Carlsson, Mahin Akbarzadeh, Pallonji Bhiladvala, Anders Roijer, David Nordlund, Peter Höglund, David Zughaft, Lizbet Todorova, Arash Mokhtari, Håkan Arheden, David Erlinge, Ulf Ekelund
OBJECTIVE: Recent studies suggest that administration of O2 in patients with acute myocardial infarction may have negative effects. With the use of cardiac MRI (CMR), we evaluated the effects of supplemental O2 in patients with ST elevation myocardial infarction (STEMI) accepted for acute percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This study was a randomized-controlled trial conducted at two university hospitals in Sweden. Normoxic STEMI patients were randomized in the ambulance to either supplemental O2 (10 l/min) or room air until the conclusion of the PCI...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27879535/agreement-between-arterial-and-venous-lactate-in-emergency-department-patients-a-prospective-study-of-157-consecutive-patients
#11
Anne-Laure Paquet, Vanina Valli, Anne-Laure Philippon, Catherine Devilliers, Ben Bloom, Pierre Hausfater, Bruno Riou, Yonathan Freund
INTRODUCTION: In the emergency department (ED), lactate is routinely used for risk stratification. Whether venous or arterial lactate measured on blood gas is interchangeable is not known. We hypothesized that venous lactate can be used instead of arterial lactate for the evaluation of acute patients in the ED. PATIENTS AND METHODS: This was a prospective single-center study. All patients requiring a lactate measurement were enrolled and we simultaneously drew arterial and venous blood...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27879534/physician-provided-prehospital-critical-care-effect-on-patient-physiology-dynamics-and-on-scene-time
#12
Bjørn O Reid, Marius Rehn, Oddvar Uleberg, Andreas J Krüger
INTRODUCTION: Improved physiologic status can be seen as a surrogate measure of improved outcome and a field-friendly prognostic model such as the Mainz Emergency Evaluation Score (MEES) could quantify the effect on physiological response. We aim to examine the dynamic physiological profile as measured by this score on patients managed by physician-manned helicopter emergency medical services and how this profile was related to on-scene time expenditure and critical care interventions...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27870662/introducing-copayments-in-the-emergency-department-would-deter-appropriate-visits-in-the-netherlands
#13
Nicole Kraaijvanger, Douwe Rijpsma, Henk van Leeuwen, Michael Edwards
OBJECTIVE: To determine what the effects of introduction of copayments for self-referred emergency department (ED) visits would be in the Netherlands and at what amount patients would turn to a GP before visiting an ED. METHODS: This questionnaire study was carried out in the ED of the Rijnstate Hospital, a community teaching hospital in the Netherlands. In the Netherlands, a deductible excess system is in use and this study investigated the effects of a copayment for self-referred patients (SRPs) on top of the deductible excess...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27759571/workplace-chemical-and-toxin-exposures-reported-to-a-poisons-information-centre-a-diverse-range-causing-variable-morbidity
#14
Sophia L-Y Ling, David McD Taylor, Jeffery Robinson
OBJECTIVE: The aim of this study is to determine the period prevalence, nature and causes of workplace chemical and toxin exposures reported to the Victorian Poisons Information Centre (VPIC). PATIENTS AND METHODS: All cases classified as 'workplace: acute' when entered into the VPIC database (June 2005-December 2013) were analysed. Data were collected on patient sex, the nature of the chemical or toxin, route of exposure and season. RESULTS: Overall, 4928 cases were extracted...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27755124/telemedicine-based-physician-consultation-results-in-more-patients-treated-and-released-by-ambulance-personnel
#15
Nikolaj Raaber, Morten T Bøtker, Ingunn S Riddervold, Erika F Christensen, Niels-Christian Emmertsen, Thorbjørn Grøfte, Hans Kirkegaard
OBJECTIVE: We examined whether teleconsultation from ambulances to a physician at an emergency medical communication center (EMCC) would increase the proportion of patients with nonurgent conditions being treated and released on site. METHODS: This research was a before-after pilot study. In the intervention period, the EMCC was manned 24/7 with physicians experienced in emergency care. Eligible participants included all patients with nonurgent conditions receiving an ambulance after a medical emergency call...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27749377/characteristics-and-predictors-of-mortality-among-frequent-users-of-an-emergency-department-in-switzerland
#16
Judith L Griffin, Marie Yersin, Stéphanie Baggio, Katia Iglesias, Venetia-Sofia Velonaki, Karine Moschetti, Bernard Burnand, Jean-Blaise Wasserfallen, Francis Vu, Corine Ansermet, Olivier Hugli, Jean-Bernard Daeppen, Patrick Bodenmann
OBJECTIVES: Frequent Emergency Department (ED) users have an elevated mortality, yet little is known about risk factors. Our aim was to characterize deceased frequent ED users and determine predictors of mortality. METHODS: This is a post-hoc analysis of all-cause mortality among frequent ED users participating in a randomized clinical trial on case management at the Lausanne University Hospital (Switzerland). We enrolled 250 frequent ED users (5+ visits/past year) in a 12-month randomized clinical trial; those with an estimated survival of fewer than 18 months were excluded...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27603200/virtual-laboratory-and-imaging-an-online-simulation-tool-to-enhance-hospital-disaster-preparedness-training-experience
#17
Luca Carenzo, Francesco Ragozzino, Davide Colombo, Federico Lorenzo Barra, Francesco Della Corte, Pier Luigi Ingrassia
OBJECTIVE: Hospitals play a pivotal role as basic healthcare providers during mass casualty incidents (MCIs). Radiological studies and emergency laboratory test are of high importance for the management of hospital patients. However, it is known that during these events, they can generate significant bottlenecks. Appropriate request of such tests is of utmost importance to not generate delays in the patient flow. The aim of this paper is to describe a software designed to increase the realism of hospital-based MCI training through a realistic reproduction of radiology and laboratory departments...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27547885/characteristics-treatment-and-outcomes-for-all-emergency-department-patients-fulfilling-criteria-for-septic-shock-a-prospective-observational-study
#18
Julian M Williams, Jaimi H Greenslade, Chelsea A Dymond, Kevin Chu, Anthony F T Brown, Jeffrey Lipman
OBJECTIVE: Most published data on emergency department (ED) patients with septic shock have been generated from studies examining the effect of early protocolised resuscitation in selected cohorts. Consequently, these data do not generally represent patients falling outside trial inclusion criteria or judged unsuitable for aggressive treatment. Our aim was to determine the characteristics, treatment and outcomes for all ED patients fulfilling the criteria for septic shock. METHODS: Septic shock patients were identified from a prospective database of consecutive ED patients admitted with infection...
April 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27172392/nonspecific-abdominal-pain-in-the-emergency-department-malignancy-incidence-in-a-nationwide-swedish-cohort-study
#19
Pia Ferlander, Cecilia Elfström, Katarina Göransson, Anette von Rosen, Therese Djärv
INTRODUCTION: The role of emergency physicians is to identify patients in need of immediate treatment, but also to identify symptoms indicative of serious, if not immediately life-threatening conditions. AIM: To assess whether symptoms described as nonspecific abdominal pain (NSAP) could be the first indication of an abdominal malignancy. MATERIALS AND METHODS: This was a nationwide registry-based cohort study of all patients discharged with NSAP from Swedish Emergency Departments (EDs) during the year 2011, based on Swedish patient registries of inpatient and outpatient care, and the cause of death registry, studying patients diagnosed with de novo cancer within a year after their NSAP discharge...
April 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
#20
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)...
February 16, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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