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BMC Emergency Medicine

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https://www.readbyqxmd.com/read/27894249/brief-compression-only-cardiopulmonary-resuscitation-training-video-and-simulation-with-homemade-mannequin-improves-cpr-skills
#1
Gregory K Wanner, Arayel Osborne, Charlotte H Greene
BACKGROUND: Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt)...
November 29, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27835981/testing-a-videogame-intervention-to-recalibrate-physician-heuristics-in-trauma-triage-study-protocol-for-a-randomized-controlled-trial
#2
Deepika Mohan, Matthew R Rosengart, Baruch Fischhoff, Derek C Angus, Coreen Farris, Donald M Yealy, David J Wallace, Amber E Barnato
BACKGROUND: Between 30 and 40 % of patients with severe injuries receive treatment at non-trauma centers (under-triage), largely because of physician decision making. Existing interventions to improve triage by physicians ignore the role that intuition (heuristics) plays in these decisions. One such heuristic is to form an initial impression based on representativeness (how typical does a patient appear of one with severe injuries). We created a video game (Night Shift) to recalibrate physician's representativeness heuristic in trauma triage...
November 11, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27829367/intranasal-ketamine-for-acute-traumatic-pain-in-the-emergency-department-a-prospective-randomized-clinical-trial-of-efficacy-and-safety
#3
Shachar Shimonovich, Roy Gigi, Amir Shapira, Tal Sarig-Meth, Danielle Nadav, Mattan Rozenek, Debra West, Pinchas Halpern
BACKGROUND: Ketamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study was to elucidate the efficacy and adverse effects of a sub-dissociative dose of IN Ketamine compared to IV and IM morphine. METHODS: A single-center, randomized, prospective, parallel clinical trial of efficacy and safety of IN ketamine compared to IV and IM morphine for analgesia in the emergency department (ED)...
November 9, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27809769/retrospective-analysis-of-management-of-ingested-foreign-bodies-and-food-impactions-in-emergency-endoscopic-setting-in-adults
#4
Girolamo Geraci, Carmelo Sciume', Giovanni Di Carlo, Antonino Picciurro, Giuseppe Modica
BACKGROUND: Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014. METHODS: This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. We reviewed patients' database (age, sex, type of foreign body and its anatomical location, treatments, and outcomes as complications, success rates, and mortalities)...
November 4, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27769180/comparison-of-antimicrobial-resistance-patterns-of-esbl-and-non-esbl-bacterial-isolates-among-patients-with-secondary-peritonitis-at-bugando-medical-centre-mwanza-tanzania
#5
Jeremiah Seni, Enock Sweya, Amri Mabewa, Stephen E Mshana, Japhet M Gilyoma
BACKGROUND: Secondary peritonitis is a common surgical emergence with deadly outcomes when not timely and promptly intervened. The emergence of Extended spectrum beta lactamase producing bacteria (ESBL) poses treatment challenge at Bugando Medical Centre (BMC); hence a need to evaluate the magnitude of ESBL so as to guide specific therapy. METHODS: This was a cross sectional study conducted at BMC from May 2014 to April 2015 involving patients with secondary peritonitis...
October 21, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27737641/dispatch-guideline-adherence-and-response-interval-a-study-of-emergency-medical-calls-in-norway
#6
Eirin N Ellensen, Torben Wisborg, Steinar Hunskaar, Erik Zakariassen
BACKGROUND: The Emergency Medical Communication Centre (EMCC) operators in Norway report using the Norwegian Index for Medical Emergency Assistance (Index), a criteria-based dispatch guideline, in about 75 % of medical emergency calls. The main purpose of a dispatch guideline is to assist the operator in securing a correct response as quickly as possible. The effect of using the guideline on EMCC response interval is as yet unknown. We wanted to ascertain an objective measure of guideline adherence, and explore a possible effect on emergency medical dispatch (EMD) response interval...
October 13, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27658706/primary-triage-nurses-do-not-divert-patients-away-from-the-emergency-department-at-times-of-high-in-hospital-bed-occupancy-a-retrospective-cohort-study
#7
Mathias C Blom, Karin Erwander, Lars Gustafsson, Mona Landin-Olsson, Fredrik Jonsson, Kjell Ivarsson
BACKGROUND: Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage...
September 22, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27655080/outcomes-associated-with-observation-versus-short-stay-admission-among-chest-pain-patients-in-the-veterans-health-administration
#8
Brad Wright, Amy M J O'Shea, Justin M Glasgow, Padmaja Ayyagari, Mary Vaughan-Sarrazin
BACKGROUND: To determine the extent to which 30- and 90-day hospital readmission and mortality rates differ as a function of whether a chest pain patient is placed in observation status or admitted to the hospital for a short-stay (<48 h). METHODS: Using 114,043 observation stays and short-stay admissions for chest pain at Veterans Health Administration hospitals between 2005 and 2013, we estimated event-level logistic regression models using a generalized estimating equation framework to predict 30 and 90-day readmissions and mortality as a function of whether the patient had an observation stay or a short-stay admission...
September 21, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27619651/keep-it-simple-vascular-risk-factors-and-focal-exam-findings-correctly-identify-posterior-circulation-ischemia-in-dizzy-patients
#9
Karen Chen, Andrea L C Schneider, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Dizziness is a common chief complaint of patients presenting to the Emergency Department (ED). Physicians must quickly and accurately identify patients whose etiology is most likely ischemia. Additional tools are available, but often require further training (vestibular testing) or are costly and not always readily available (magnetic resonance imaging (MRI)). This study evaluates the ability of a routine history and simple physical examination to correctly identify dizzy patients with posterior circulation ischemia, and the added utility of CT angiography (CTA)...
September 13, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27577952/heart-fatty-acid-binding-protein-and-cardiac-troponin-development-of-an-optimal-rule-out-strategy-for-acute-myocardial-infarction
#10
Joanna M Young, John W Pickering, Peter M George, Sally J Aldous, John Wallace, Chris M Frampton, Richard W Troughton, Mark A Richards, Jaimi H Greenslade, Louise Cullen, Martin P Than
BACKGROUND: Improved ability to rapidly rule-out Acute Myocardial Infarction (AMI) in patients presenting with chest pain will promote decongestion of the Emergency Department (ED) and reduce unnecessary hospital admissions. We assessed a new commercial Heart Fatty Acid Binding Protein (H-FABP) assay for additional diagnostic value when combined with cardiac troponin (using a high sensitivity assay). METHODS: H-FABP and high-sensitivity troponins I (hs-cTnI) and T (hs-cTnT) were measured in samples taken on-presentation from patients, attending the ED, with symptoms triggering investigation for possible acute coronary syndrome...
August 31, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27549755/prospective-evaluation-of-an-automated-method-to-identify-patients-with-severe-sepsis-or-septic-shock-in-the-emergency-department
#11
Samuel M Brown, Jason Jones, Kathryn Gibb Kuttler, Roger K Keddington, Todd L Allen, Peter Haug
BACKGROUND: Sepsis is an often-fatal syndrome resulting from severe infection. Rapid identification and treatment are critical for septic patients. We therefore developed a probabilistic model to identify septic patients in the emergency department (ED). We aimed to produce a model that identifies 80 % of sepsis patients, with no more than 15 false positive alerts per day, within one hour of ED admission, using routine clinical data. METHODS: We developed the model using retrospective data for 132,748 ED encounters (549 septic), with manual chart review to confirm cases of severe sepsis or septic shock from January 2006 through December 2008...
August 22, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27465304/epidemiology-and-outcomes-of-out-of-hospital-cardiac-arrest-in-a-developing-country-a-multicenter-cohort-study
#12
Minaz Mawani, Muhammad Masood Kadir, Iqbal Azam, Amber Mehmood, Bryan McNally, Kent Stevens, Rozina Nuruddin, Mohammad Ishaq, Junaid Abdul Razzak
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death and disability worldwide. Overall survival after an OHCA has been reported to be poor and limited studies have been conducted in developing countries. We aimed to investigate the rates of survival from OHCA and explore components of the chain of survival in a developing country. METHODS: We conducted a multicenter prospective cohort study in the emergency departments (ED) of five major public and private sector hospitals of Karachi, Pakistan from January 2013 to April 2013...
July 28, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27412243/prediction-of-90-day-mortality-in-older-patients-after-discharge-from-an-emergency-department-a-retrospective-follow-up-study
#13
Susanna E Hofman, Jacinta A Lucke, Noor Heim, Jelle de Gelder, Anne J Fogteloo, Christian Heringhaus, Bas de Groot, Anton J M de Craen, Gerard Jan Blauw, Simon P Mooijaart
BACKGROUND: Older people frequently attend the emergency department (ED) and have a high risk of poor outcome as compared to their younger counterparts. Our aim was to study routinely collected clinical parameters as predictors of 90-day mortality in older patients attending our ED. METHODS: We conducted a retrospective follow-up study at the Leiden University Medical Center (The Netherlands) among patients aged 70 years or older attending the ED in 2012. Predictors were age, gender, time and way of arrival, presenting complaint, consulting medical specialty, vital signs, pain score and laboratory testing...
July 13, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27405926/the-cpr-outcomes-of-online-medical-video-instruction-versus-on-scene-medical-instruction-using-simulated-cardiac-arrest-stations
#14
Chaiyaporn Yuksen, Sorravit Sawatmongkornkul, Jarupol Tuangsirisup, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
BACKGROUND: Non-traumatic cardiac arrest is a fatal emergency condition. Its survival rate and outcomes may be better with quick and effective cardiopulmonary resuscitation (CPR). Telemedicine such as telephone or real time video has been shown to improve chest compression procedures. There are limited data on the effects of telemedicine in cardiac arrest situations in the literature particularly in Asian settings. METHODS: This study was conducted by using two simulated cardiac arrest stations during the 2014 annual Thai national conference in emergency medicine...
July 12, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27301490/a-generic-method-for-evaluating-crowding-in-the-emergency-department
#15
Andreas Halgreen Eiset, Mogens Erlandsen, Anders Brøns Møllekær, Julie Mackenhauer, Hans Kirkegaard
BACKGROUND: Crowding in the emergency department (ED) has been studied intensively using complicated non-generic methods that may prove difficult to implement in a clinical setting. This study sought to develop a generic method to describe and analyse crowding from measurements readily available in the ED and to test the developed method empirically in a clinical setting. METHODS: We conceptualised a model with ED patient flow divided into separate queues identified by timestamps for predetermined events...
June 14, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27048405/higher-diagnostic-accuracy-and-cost-effectiveness-using-procalcitonin-in-the-treatment-of-emergency-medicine-patients-with-fever-the-hitemp-study-a-multicenter-randomized-study
#16
RANDOMIZED CONTROLLED TRIAL
Yuri van der Does, Maarten Limper, Stephanie C E Schuit, Marten J Poley, Joost van Rosmalen, Christian Ramakers, Peter Patka, Eric C M van Gorp, Pleunie P M Rood
BACKGROUND: Fever is a common symptom in the emergency department(ED). Fever can be caused by bacterial infections, which are treated with antibiotics. Often, bacterial infections cannot be ruled out in the ED using standard diagnostics, and empiric antibiotic treatment is started. Procalcitonin(PCT) is a biomarker for bacterial infections, but its role in an undifferentiated ED population remains unclear. We hypothesize that PCT-guided therapy may reduce antibiotics prescription in undifferentiated febrile ED patients...
April 6, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/26860825/a-practical-method-for-predicting-frequent-use-of-emergency-department-care-using-routinely-available-electronic-registration-data
#17
Jianmin Wu, Shaun J Grannis, Huiping Xu, John T Finnell
BACKGROUND: Accurately predicting future frequent emergency department (ED) utilization can support a case management approach and ultimately reduce health care costs. This study assesses the feasibility of using routinely collected registration data to predict future frequent ED visits. METHOD: Using routinely collected registration data in the state of Indiana, U.S.A., from 2008, we developed multivariable logistic regression models to predict frequent ED visits in the subsequent two years...
February 9, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/26781953/emergency-department-visits-for-head-trauma-in-the-united-states
#18
Christopher E Gaw, Mark R Zonfrillo
BACKGROUND: Head trauma affects millions of Americans each year and has significant morbidity and economic costs to society. The objective of this study is to describe the epidemiology of head traumas presenting to emergency departments in the United States. METHODS: The National Electronic Injury Surveillance System-All Injury Program was queried to conduct a retrospective analysis of head traumas treated in U.S. emergency departments. 207,159 cases of nonfatal head trauma from January 1, 2007 to December 31, 2011 were included in this study...
January 19, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/26772732/development-and-validation-of-clinical-performance-assessment-in-simulated-medical-emergencies-an-observational-study
#19
Aysen Erdogan, Yue Dong, Xiaomei Chen, Christopher Schmickl, Ronaldo A Sevilla Berrios, Lisbeth Y Garcia Arguello, Rahul Kashyap, Oguz Kilickaya, Brian Pickering, Ognjen Gajic, John C O'Horo
BACKGROUND: Critical illness is a time-sensitive process which requires practitioners to process vast quantities of data and make decisions rapidly. We have developed a tool, the Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN), aimed at enhancing care delivery in such situations. To determine the efficacy of CERTAIN and similar cognitive aids, we developed rubric for evaluating provider performance in a simulated medical resuscitation environments. METHODS: We recruited 18 clinicians with current valid ACLS certification for evaluation in three simulated medical scenarios designed to mimic typical medical decompensation events routinely experienced in clinical care...
January 15, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/26748777/pattern-of-acute-poisoning-at-two-urban-referral-hospitals-in-lusaka-zambia
#20
Jessy Z'gambo, Yorum Siulapwa, Charles Michelo
BACKGROUND: Poisoning remains an important public health problem contributing significantly to the global burden of disease. Evidence on the exact burden and pattern of acute poisoning in Zambia is limited. We aimed to characterise acute poisoning with regard to demographic and epidemiologic factors of cases reported at the University Teaching Hospital and Levy Mwanawasa General Hospital; two large referral hospitals in Lusaka, Zambia. METHODS: This was a cross-sectional study involving retrospective collection of data on all poisoning cases recorded in hospital records from 1 January to 31 December 2012...
January 9, 2016: BMC Emergency Medicine
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