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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/28099182/reliability-of-the-revised-swiss-emergency-triage-scale-a-computer-simulation-study
#1
Olivier T Rutschmann, Olivier W Hugli, Christophe Marti, Olivier Grosgurin, Antoine Geissbuhler, Michel Kossovsky, Josette Simon, François P Sarasin
BACKGROUND: The Swiss Emergency Triage Scale (SETS) is a four-level emergency scale that previously showed moderate reliability and high rates of undertriage due to a lack of standardization. It was revised to better standardize the measurement and interpretation of vital signs during the triage process. OBJECTIVE: The aim of this study was to explore the inter-rater and test-retest reliability, and the rate of correct triage of the revised SETS. PATIENTS AND METHODS: Thirty clinical scenarios were evaluated twice at a 3-month interval using an interactive computerized triage simulator by 58 triage nurses at an urban teaching emergency department admitting 60 000 patients a year...
February 14, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28151752/influences-on-emergency-department-length-of-stay-for-older-people
#2
Maryann Street, Mohammadreza Mohebbi, Debra Berry, Anthony Cross, Julie Considine
OBJECTIVE: The aim of this study was to examine the influences on emergency department (ED) length of stay (LOS) for older people and develop a predictive model for an ED LOS more than 4 h. METHODS: This retrospective cohort study used organizational data linkage at the patient level from a major Australian health service. The study population was aged 65 years or older, attending an ED during the 2013/2014 financial year. We developed and internally validated a clinical prediction rule...
February 1, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28145941/lessons-learned-in-applying-the-international-society-for-pharmacoeconomics-and-outcomes-research-methodology-to-translating-canadian-emergency-department-information-system-presenting-complaints-list-into-german
#3
Dominik Brammen, Felix Greiner, Harald Dormann, Carsten Mach, Christian Wrede, Anne Ballaschk, Declan Stewart, Steven Walker, Christine Oesterling, Martin Kulla
OBJECTIVES: The patient's presenting complaint guides diagnosis and treatment in the emergency department, but there is no classification system available in German. The Canadian Emergency Department Information System (CEDIS) Presenting Complaint List (PCL) is available only in English and French. As translation risks the altering of meaning, the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) has set guidelines to ensure translational accuracy. The aim of this paper is to describe our experiences of using the ISPOR guidelines to translate the CEDIS PCL into German...
January 31, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28125429/which-indicators-to-include-in-a-crowding-scale-in-an-emergency-department-a-national-french-delphi-study
#4
Guilhem Noel, Camille Drigues, Gilles Viudes
BACKGROUND: Emergency department (ED) crowding is a serious international public health issue with a negative impact on quality of care. Despite two decades of research, there is no consensus on the indicators used to quantify crowding. The aim of our study was to select the most valid ED crowding indicators. MATERIALS AND METHODS: The Delphi method was used. Selected indicators originated from a literature review and propositions from FEDORU (National Emergency Department Observatory Network) workgroup...
January 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28118319/no-more-winter-crisis-forecasting-daily-bed-requirements-for-emergency-department-admissions-to-hospital
#5
Mathias Wargon, Dominique Brun-Ney, Laure Beaujouan, Enrique Casalino
STUDY HYPOTHESIS: We hypothesized that age, calendar variables, and clinical influenza epidemics may have an impact on the number of daily through-emergency department (ED) hospitalizations. The aim of our study was to elaborate a pragmatic tool to predict the daily number of through-ED hospitalizations. METHODS: We carried out a prospective-observational study including data from 18 ED located in the Paris metropolitan area. Daily through-ED hospitalizations numbers from 2007 to 2010 were modelized to forecast the year 2011 using a general linear model by age groups (<75-years; ≥75-years) using calendar variables and influenza epidemics as explanatory variables...
January 25, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28118320/characteristics-of-children-with-microbiologically-confirmed-invasive-bacterial-infections-in-the-emergency-department
#6
Iker Gangoiti, Juan R Valle, Mercedes Sota, Lorea Martinez-Indart, Javier Benito, Santiago Mintegi
BACKGROUND: Determination of the characteristics of paediatric invasive bacterial infections (IBI) is essential for early identification of children requiring immediate antibiotic therapy. The main objective is to characterize the emergency presentation of the IBI among children aged younger than 14 years. PATIENTS AND METHODS: A prospective registry-based cohort study including all patients aged younger than 14 years diagnosed with confirmed IBI (culture or genomic detection using the polymerase chain reaction) was carried out in a paediatric emergency department between 2008 and 2015...
January 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28099181/adverse-events-and-risk-factors-during-emergency-intubation-in-a-tertiary-paediatric-emergency-department
#7
Ruth M C Löllgen, Jennifer Pontin, Matthew Gow, Mary E McCaskill
BACKGROUND: Rapid sequence intubation and emergency intubation in the emergency department (ED) can be life-saving procedures, but require the appropriate skills, experience and preparation to avoid complications ranging from simple trauma to life-threatening desaturation. Only scarce data exist in the published literature on complications following emergency intubation in children and most guidelines are extrapolated from the adult population. PATIENTS AND METHODS: We reviewed all emergency intubations of patients in our tertiary paediatric ED within a 2-year period to estimate the incidence of complications and to analyse the risk factors associated with this procedure...
January 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28079562/can-an-age-adjusted-d-dimer-level-be-adopted-in-managing-venous-thromboembolism-in-the-emergency-department-a-retrospective-cohort-study
#8
Tom Jaconelli, Mazin Eragat, Steven Crane
INTRODUCTION: Patients suspected of having venous thromboembolism (VTE), with a low pretest probability, undergo D-dimer testing. A negative D-dimer, in a low-risk patient rules out VTE with a high degree of certainty because of its high sensitivity. It is, however, a poorly specific test, and the absolute value increases with age. The aim of this study was to establish whether an age-adjusted D-dimer could be safely used instead of a standard cut-off level in low-risk patients over the age of 50 years...
January 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28079561/-single-checked-patient-group-directions-during-initial-nurse-assessment-within-paediatric-emergency-departments-of-the-uk-and-ireland
#9
Chris K Bird, Anthony G Sinclair, Stuart Hartshorn
OBJECTIVE: Double checking medications at initial assessment within paediatric emergency departments (EDs) has the potential to delay patient flow, and doubt has been cast on the efficacy of double checking in all but high-risk medications. We aimed to benchmark current practice for the use of Patient Group Direction (PGD) medications at initial assessment in EDs within the Paediatric Emergency Research UK and Ireland (PERUKI) network, with a focus on the use of 'single-checker' PGDs...
January 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28059860/diagnosis-and-treatment-of-upper-airway-oedema-caused-by-acute-angio-oedema-in-the-emergency-department-a-french-consensus-statement
#10
Bernard Floccard, Nicolas Javaud, Alban Deroux, Isabelle Boccon-Gibod, Olivier Fain, Stéphanie Amarger, Claire Blanchard-Delaunay, Pierre Y Jeandel, Nicolas Marmion, Yann Ollivier, Pauline Pralong, Stéphane Gayet, Aurélie Du-Thanh, Fabien Pelletier, Laurent Sailler, Philip Robinson, David Launay, Laurence Bouillet
Angio-oedema is a transitory, localized, noninflammatory oedema of subcutaneous tissue or mucous. When the oedema affects the mouth, lips, tongue or larynx, it can result in fatal asphyxiation in the absence of specific treatment. Oedema secondary to plasma extravasation is usually mediated by either histamine or bradykinin. As laboratory tests are not available in an emergency setting, the implicated mediator cannot be readily determined. The challenge for the emergency physician is to determine the aetiological type, evaluate severity and initiate adapted treatment by means of a structured approach...
January 4, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28027074/a-randomized-controlled-trial-of-a-patient-centred-intervention-in-high-risk-discharged-older-patients
#11
Glenn Arendts, Kate Bullow, Christopher Etherton-Beer, Ellen MacDonald, Sandra Dumas, Yusuf Nagree, Simon G A Brown, Osvaldo P Almeida
BACKGROUND: The risk of early reattendance after discharge has been proposed as a performance indicator for emergency departments (EDs), but is not uniform in all patients. Those individuals at the highest risk of reattendance may benefit from an intense intervention to reduce this risk, and our objective was to test this hypothesis in a clinical trial. METHODS: A randomized-controlled trial was conducted in the EDs of two hospitals. Very high-risk adults aged 65 years and older, identified using a validated risk-prediction nomogram and being discharged from ED, were randomized to receive a postdischarge patient-centred intervention or standard care...
December 23, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28027073/value-of-the-coronary-artery-disease-consortium-rule-in-patients-with-acute-chest-pain-and-negative-troponins-referred-for-exercise-stress-testing
#12
Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J Broullón, Ramón Calviño-Santos, Víctor X Mosquera, Dolores Martínez, Juan C Yáñez, Nemesio Álvarez-García, José M Vázquez-Rodríguez
OBJECTIVE: To assess the value of the pretest probability (PTP) of coronary artery disease (CAD) for predicting stress testing results and coronary events in patients with acute chest pain and negative troponins. PATIENTS AND METHODS: A total of 3527 patients without a history of CAD referred to our chest pain unit with suspected acute coronary syndromes, nondiagnostic ECGs, and negative troponin levels underwent exercise stress testing. PTP was estimated with the CAD consortium prediction rule, and was categorized as low (<15%), low-intermediate (15-65%), intermediate-high (66-85%), and high (>85%)...
December 23, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28002090/prognostic-value-of-infrared-thermography-in-an-emergency-department
#13
Jesper K Holm, John G Kellett, Nadia H Jensen, Søren N Hansen, Kristian Jensen, Mikkel Brabrand
OBJECTIVE: In this study, we aimed to investigate the prognostic potential of infrared thermography in a population of medical patients admitted to the emergency department. Central-to-peripheral temperature gradients were analyzed for association with 30-day mortality. METHODS: This prospective observational study included 198 medical patients admitted to the Emergency Department, at Odense University Hospital. A standardized thermal picture was taken and temperatures of the inner canthus, the earlobe, the nose tip, and the tip of the third finger were reported...
December 20, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28002070/retrospective-validation-of-the-pulmonary-embolism-rule-out-criteria-rule-in-pe-unlikely-patients-with-suspected-pulmonary-embolism
#14
Steven Crane, Tom Jaconelli, Mazin Eragat
INTRODUCTION: Patients presenting to emergency departments (EDs) with suspected pulmonary embolism (PE) can be risk stratified and those who are deemed to be at low risk for PE usually undergo D-dimer testing. A negative D-dimer in this low-risk group rules out PE with a high degree of certainty because of its high sensitivity. The D-dimer is, however, a poorly specific test and positive results often lead to unnecessary radiological imaging (notably computed tomography pulmonary angiography)...
December 19, 2016: 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
#15
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...
December 6, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27906818/impact-of-a-general-practitioners-strike-and-of-terrorist-attacks-on-a-call-centre
#16
Paul-Georges Reuter, Charlotte Orsini, Mélanie Grave, Frédéric Linval, Hayatte Akodad, Laurent Goix, Frédéric Adnet, Frédéric Lapostolle
OBJECTIVE: We aimed to evaluate the impact of the same-day GPs' strike and terrorist attacks on a call centre's activity. METHODS: We compared the number of calls received, the number of patient's medical files (PMFs) created and the number of mobile ICU (MICU) dispatched per hour on Friday, 13 November, to the repository established on the five previous Fridays. As previously published, the variation criterion was set to an activity variation above 20% for more than 2 h...
November 30, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28225366/reviewing-papers-for-publication-privilege-pain-or-perhaps-a-responsibility
#17
Colin A Graham
No abstract text is available yet for this article.
April 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26287804/which-adverse-events-should-be-reported-in-an-emergency-department-a-delphi-study
#18
Susan M Robinson, Ben F Walker, Ruth M Brown
OBJECTIVE: The aim of this study was to determine if emergency medicine specific triggers for completing an incident form could be agreed and if a common definition for contributory factors could be achieved. Such definitions could be used to improve safety within the emergency department (ED) and share learning across the specialty. PARTICIPANTS AND METHODS: One hundred and fifteen ED safety leads in the UK and Ireland were invited to participate in a Delphi study...
April 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/26287803/ecg-interpretation-in-emergency-department-residents-an-update-and-e-learning-as-a-resource-to-improve-skills
#19
Francois X Barthelemy, Julien Segard, Philippe Fradin, Nicolas Hourdin, Eric Batard, Pierre Pottier, Gilles Potel, Emmanuel Montassier
OBJECTIVE: ECG interpretation is a pivotal skill to acquire during residency, especially for Emergency Department (ED) residents. Previous studies reported that ECG interpretation competency among residents was rather low. However, the optimal resource to improve ECG interpretation skills remains unclear. The aim of our study was to compare two teaching modalities to improve the ECG interpretation skills of ED residents: e-learning and lecture-based courses. PARTICIPANTS AND METHODS: The participants were first-year and second-year ED residents, assigned randomly to the two groups...
April 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27984372/intubation-success-rates-of-prehospital-rapid-sequence-induction
#20
Joost Peters, Bas Van Wageningen, Ilze Hendriks, Ruud Eijk, Michael Edwards, Nico Hoogerwerf, Jan Biert
No abstract text is available yet for this article.
February 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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