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BMC Emergency Medicine

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https://www.readbyqxmd.com/read/28228127/a-review-of-enhanced-paramedic-roles-during-and-after-hospital-handover-of-stroke-myocardial-infarction-and-trauma-patients
#1
Darren Flynn, Richard Francis, Shannon Robalino, Joanne Lally, Helen Snooks, Helen Rodgers, Graham McClelland, Gary A Ford, Christopher Price
BACKGROUND: Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. We aimed to categorize and synthesise data from studies describing development/extension of the ambulance-based paramedic role during and after handover for time-critical conditions (trauma, stroke and myocardial infarction)...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28228110/a-nationwide-survey-of-first-aid-training-and-encounters-in-norway
#2
Håkon Kvåle Bakke, Tine Steinvik, Johan Angell, Torben Wisborg
BACKGROUND: Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish the prevalence and distribution of first aid training in the populace, how often first aid skills are needed, and self-reported helping behaviour. METHODS: We conducted a telephone survey of 1000 respondents who were representative of the Norwegian population...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28122490/erratum-to-factors-affecting-the-exposure-vulnerability-and-emergency-medical-service-capacity-for-victims-of-road-traffic-incidents-in-kampala-metropolitan-area-a-delphi-study
#3
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati, Stephen Kasiima
No abstract text is available yet for this article.
January 25, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28103818/a-qualitative-study-to-identify-barriers-to-deployment-and-student-training-in-the-use-of-automated-external-defibrillators-in-schools
#4
Line Zinckernagel, Carolina Malta Hansen, Morten Hulvej Rod, Fredrik Folke, Christian Torp-Pedersen, Tine Tjørnhøj-Thomsen
BACKGROUND: Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates have been observed, and even at schools with a defibrillator, challenges such as delayed access have been reported. The purpose of this study was to identify barriers to the implementation of defibrillator training of students and deployment of defibrillators in schools...
January 19, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28068917/emergency-department-presentations-for-atrial-fibrillation-and-flutter-in-alberta-a-large-population-based-study
#5
Rhonda J Rosychuk, Michelle M Graham, Brian R Holroyd, Brian H Rowe
BACKGROUND: Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta. METHODS: Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Data extracted included demographics, ED visit timing, and subsequent visits to non-ED settings...
January 10, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28061754/factors-affecting-the-exposure-vulnerability-and-emergency-medical-service-capacity-for-victims-of-road-traffic-incidents-in-kampala-metropolitan-area-a-delphi-study
#6
Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani Zavareh, Amir Nejati, Stephen Kasiima
BACKGROUND: The Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in motorized vehicles which, predisposes the region to a high risk of road traffic incidents (RTIs). A number of concerted road safety and post-crash management measures to respond to RTIs in the KMA in particular and Uganda as a whole have been undertaken. However, there is a need to greatly improve the measures by better identifying the factors influencing the exposure, vulnerability and emergency medical service (EMS) capacity for RTI victims...
January 7, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27927189/prehospital-critical-care-for-out-of-hospital-cardiac-arrest-an-observational-study-examining-survival-and-a-stakeholder-focused-cost-analysis
#7
Johannes von Vopelius-Feldt, Jane Powell, Richard Morris, Jonathan Benger
BACKGROUND: Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical care teams (CCTs) which attend critically ill patients, including OHCA. However, current scientific evidence describing CCTs attending OHCA is sparse and research to date has not demonstrated clear benefits from this model of care. METHODS: This prospective, observational study will describe the effect of CCTs on survival from OHCA, when compared to advanced-life-support (ALS), the current standard of prehospital care in the UK...
December 7, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27912757/the-sydney-triage-to-admission-risk-tool-start-to-predict-emergency-department-disposition-a-derivation-and-internal-validation-study-using-retrospective-state-wide-data-from-new-south-wales-australia
#8
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27894249/brief-compression-only-cardiopulmonary-resuscitation-training-video-and-simulation-with-homemade-mannequin-improves-cpr-skills
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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/27590310/barriers-in-detecting-elder-abuse-among-emergency-medical-technicians
#18
Jennifer M Reingle Gonzalez, M Brad Cannell, Katelyn K Jetelina, Sepeadeh Radpour
BACKGROUND: Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians' (EMTs), despite state-mandated reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. The objective was to describe EMTs' experience detecting and reporting elder abuse. METHODS: Qualitative data were collected from 11 EMTs and 12 Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups...
September 2, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27578062/the-incorporation-of-focused-history-in-checklist-for-early-recognition-and-treatment-of-acute-illness-and-injury
#19
Namita Jayaprakash, Rashid Ali, Rahul Kashyap, Courtney Bennett, Alexander Kogan, Ognjen Gajic
BACKGROUND: Diagnostic error and delay are critical impediments to the safety of critically ill patients. Checklist for early recognition and treatment of acute illness and injury (CERTAIN) has been developed as a tool that facilitates timely and error-free evaluation of critically ill patients. While the focused history is an essential part of the CERTAIN framework, it is not clear how best to choreograph this step in the process of evaluation and treatment of the acutely decompensating patient...
August 31, 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
#20
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
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