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BMC Emergency Medicine

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https://www.readbyqxmd.com/read/29788913/prevalence-and-outcome-of-injury-in-patients-visiting-the-emergency-department-of-yirgalem-general-hospital-southern-ethiopia
#1
Abel Negussie, Andarge Getie, Elias Manaye, Tamrat Tekle
BACKGROUND: Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. METHODS: A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017...
May 22, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29769024/hems-inter-facility-transfer-a-case-mix-analysis
#2
Damien Di Rocco, Mathieu Pasquier, Eric Albrecht, Pierre-Nicolas Carron, Fabrice Dami
BACKGROUND: Helicopter emergency medical services (HEMS) are popular rescue systems despite inconsistent evidence in the scientific literature to support their use for primary interventions, as well as for inter-facility transfer (IFT). There is little research about IFT by HEMS, hence questions remain about the appropriateness of this method of transport. The aim of this study was to describe a case-mix of operational and medical characteristics for IFT activity of a sole HEMS base, and identify indicators of over-triage...
May 16, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29764376/methicillin-resistant-staphylococcus-aureus-in-emergency-department-patients-in-the-united-arab-emirates
#3
Muna Al Jalaf, Hanan Fadali, Rasha Alanee, Firas Najjar, Zulfa Al Deesi, Rania M Seliem, Eric J Nilles
BACKGROUND: Since the 1990s, community-associated methicillin resistant staphylococcus aureus (CA-MRSA) has emerged as an important global cause of skin and soft tissue infections. Little is known about the epidemiology of this pathogen in the Middle East. METHODS: We conducted a prospective observational study in a single large teaching hospital in Dubai to identify the incidence of community-acquired methicillin resistant staphylococcus aureus (MRSA) among ambulatory patients presenting with purulent skin and soft tissue infections...
May 15, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29743037/a-cross-sectional-exploratory-study-of-knowledge-attitudes-and-practices-of-emergency-health-care-providers-in-the-assessment-of-child-maltreatment-in-maputo-mozambique
#4
Liliana Pinto, Adriana Lein, Raquel Mahoque, David W Wright, Scott M Sasser, Catherine A Staton
BACKGROUND: In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM). Emergency care services (ECS) play an important role in recognizing, treating, and intervening in situations of CM. We aim to identify knowledge, attitudes, and practices regarding CM among health care providers in ECS at Mavalane General Hospital in Maputo, Mozambique. METHODS: This exploratory cross-sectional study evaluates the knowledge, attitudes, and practices of health care providers to diagnose and treat cases of CM...
May 9, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29540151/anxiety-about-anxiety-a-survey-of-emergency-department-provider-beliefs-and-practices-regarding-anxiety-associated-low-risk-chest-pain
#5
Paul I Musey, John A Lee, Cassandra A Hall, Jeffrey A Kline
BACKGROUND: Approximately 80% of patients presenting to emergency departments (ED) with chest pain do not have any true cardiopulmonary emergency such as acute coronary syndrome (ACS). However, psychological contributors such as anxiety are thought to be present in up to 58%, but often remain undiagnosed leading to chronic chest pain and ED recidivism. METHODS: To evaluate ED provider beliefs and their usual practices regarding the approach and disposition of patients with low risk chest pain associated with anxiety, we constructed a 22-item survey using a modified Delphi technique...
March 14, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29514636/outcome-of-elderly-emergency-department-patients-hospitalised-on-weekends-a-retrospective-cohort-study
#6
Steffie H A Brouns, Joyce J Wachelder, Femke S Jonkers, Suze L Lambooij, Jeanne P Dieleman, Harm R Haak
BACKGROUND: Studies investigating different medical conditions and settings have demonstrated mixed results regarding the weekend effect. However, data on the outcome of elderly patients hospitalised on weekends is scarce. The objective was to compare in-hospital and two-day mortality rates between elderly emergency department (ED) patients (≥65 years) admitted on weekends versus weekdays. METHODS: A retrospective cohort study of emergency department visits of internal medicine patients ≥65 years presenting to the emergency department between 01 and 09-2010 and 31-08-2012 was conducted...
March 7, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29466948/high-inter-observer-agreement-of-observer-perceived-pain-assessment-in-the-emergency-department
#7
Martin Høhrmann Hangaard, Brian Malling, Christian Backer Mogensen
BACKGROUND: Triage is used to prioritize the patients in the emergency department. The majority of the triage systems include the patients' pain score to assess their level of acuity by using a combination of patient reported pain and observer-perceived pain; the latter therefore requires a certain degree of inter-observer agreement. The aim of the present study was to assess the inter-observer agreement of perceived pain among emergency department nurses and to evaluate if it was influenced by predetermined factors like age and gender...
February 21, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29433441/ambulance-use-is-not-associated-with-patient-acuity-after-road-traffic-collisions-a-cross-sectional-study-from-addis-ababa-ethiopia
#8
Yonas Abebe, Tolesa Dida, Engida Yisma, David M Silvestri
BACKGROUND: Africa accounts for one sixth of global road traffic deaths-most in the pre-hospital setting. Ambulance transport is expensive relative to other modes of pre-hospital transport, but has advantages in time-sensitive, high-acuity scenarios. Many countries, including Ethiopia, are expanding ambulance fleets, but clinical characteristics of patients using ambulances remain ill-defined. METHODS: This is a cross-sectional study of 662 road traffic collisions (RTC) patients arriving to a single trauma referral center in Addis Ababa, Ethiopia, over 7 months...
February 13, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29426282/correction-to-systematic-reporting-to-improve-the-emergency-medical-response-to-major-incidents-a-pilot-study
#9
Sophie Hardy, Sabina Fattah, Torben Wisborg, Lasse Raatiniemi, Trine Staff, Marius Rehn
The original article [1] contains an error whereby all authors' names were mistakenly interchanged. The original article has now been corrected to present the authors' names correctly.
February 9, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29422029/ultrasound-guided-identification-of-the-cricothyroid-membrane-in-a-patient-with-a-difficult-airway-a-case-report
#10
Hiromu Okano, Kohji Uzawa, Kunitaro Watanabe, Akira Motoyasu, Joho Tokumine, Alan Kawarai Lefor, Tomoko Yorozu
BACKGROUND: Surgical cricothyroidotomy is considered to be the last resort for management of the difficult airway. A major point for a successful surgical cricothyroidotomy is to identify the location of the cricothyroid membrane. CASE PRESENTATION: We encountered a patient with progressive respiratory distress who was anticipated to have a difficult airway due to a large neck abscess. We prepared for both awake intubation and surgical cricothyroidotomy. The cricothyroid membrane could not be identified by palpation, but was readily identified using ultrasound...
February 8, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29368642/systematic-reporting-to-improve-the-emergency-medical-response-to-major-incidents-a-pilot-study
#11
Sophie Hardy, Sabina Fattah, Torben Wisborg, Lasse Raatiniemi, Trine Staff, Marius Rehn
BACKGROUND: Major incidents affect us globally, and are occurring with increasing frequency. There is still no evidence-based standard regarding the best medical emergency response to major incidents. Currently, reports on major incidents are non-standardised and variable in quality. This pilot study examines the first systematic reports from a consensus-based, freely accessible database, aiming to identify how descriptive analysis of reports submitted to this database can be used to improve the major incident response...
January 24, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29347913/an-unusual-case-of-infective-pneumocephalus-case-report-of-pneumocephalus-exacerbated-by-continuous-positive-airway-pressure
#12
Abdus Samad Ansari, Brittany B Dennis, Dilip Shah, Winfred Baah
BACKGROUND: Pneumocephalus, illustrated by air in the cranial vault is relatively infrequent and generally associated with neurosurgery, trauma, meningitis and barotrauma. However cases of spontaneous non-traumatic pneumocephalus remain rare. While the relationship between continuous positive airway pressure (CPAP) and atraumatic pneumocephalus has been previously reported, to our knowledge the rare presentation associated with sinus wall osteomyelitis has never been described. We summarize here the case of a 67-year-old woman's acute presentation of Streptococcus salvarius infection after a sudden drop in her consciousness...
January 18, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29347908/management-and-outcomes-of-patients-presenting-with-sepsis-and-septic-shock-to-the-emergency-department-during-nursing-handover-a-retrospective-cohort-study
#13
Sami Alsolamy, Atheer Al-Sabhan, Najla Alassim, Musharaf Sadat, Eman Al Qasim, Hani Tamim, Yaseen M Arabi
BACKGROUND: Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patient conditions and is likely relevant in conditions that requires time-sensitive therapies, such as sepsis. We aimed to examine the management and outcomes of patients presenting with sepsis and septic shock to the ED during nursing handover...
January 18, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29334925/implementing-blended-learning-in-emergency-airway-management-training-a-randomized-controlled-trial
#14
Madeleine Huei Tze Kho, Keng Sheng Chew, Muhaimin Noor Azhar, Mohd Lotfi Hamzah, Kee Man Chuah, Aida Bustam, Hiang Chuan Chan
BACKGROUND: While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blended learning (BL) refers to the systematic integration of online and face-to-face learning aimed to facilitate complex thinking skills and flexible participation at a reduced financial, time and manpower cost. This study was conducted to evaluate its effectiveness in emergency airway management training...
January 15, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29273012/a-prospective-observational-cohort-study-of-patients-presenting-to-an-emergency-department-with-acute-shoulder-trauma-the-manchester-emergency-shoulder-mesh-project
#15
Michael J Callaghan, Janos P Baombe, Dan Horner, Charles E Hutchinson, Dilraj Sandher, Simon Carley
BACKGROUND: Fracture and dislocation of the shoulder are usually identifiable through the use of plain radiographs in an emergency department. However, other significant soft tissue injuries can be missed at initial presentation. This study used contrast enhanced magnetic resonance arthrography (MRA) to determine the pattern of underlying soft tissue injuries in patients with traumatic shoulder injury, loss of active range of motion, and normal plain radiography. METHODS: A prospective, observational cohort study...
December 22, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29237400/accuracy-of-acute-burns-diagnosis-made-using-smartphones-and-tablets-a-questionnaire-based-study-among-medical-experts
#16
Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg, Lucie Laflamme
BACKGROUND: Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on images viewed on a computer screen, but whether image-based analysis by experts using handheld devices is accurate remains to be determined. METHOD: A review of patient data from eight emergency centres in the Western Cape, South Africa, revealed 10 typical cases of burns commonly seen in children and adults...
December 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29212452/the-effectiveness-of-physiologically-based-early-warning-or-track-and-trigger-systems-after-triage-in-adult-patients-presenting-to-emergency-departments-a-systematic-review
#17
Francesca Wuytack, Pauline Meskell, Aislinn Conway, Fiona McDaid, Nancy Santesso, Fergal G Hickey, Paddy Gillespie, Adam J N Raymakers, Valerie Smith, Declan Devane
BACKGROUND: Changes to physiological parameters precede deterioration of ill patients. Early warning and track and trigger systems (TTS) use routine physiological measurements with pre-specified thresholds to identify deteriorating patients and trigger appropriate and timely escalation of care. Patients presenting to the emergency department (ED) are undiagnosed, undifferentiated and of varying acuity, yet the effectiveness and cost-effectiveness of using early warning systems and TTS in this setting is unclear...
December 6, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29202698/safety-and-applicability-of-a-pre-stage-public-access-ventilator-for-trained-laypersons-a-proof-of-principle-study
#18
Patricia Fuchs, Juliane Obermeier, Svend Kamysek, Martin Degner, Hannes Nierath, Henning Jürß, Hartmut Ewald, Jens Schwarz, Martin Becker, Jochen K Schubert
BACKGROUND: Contemporary resuscitation guidelines for basic life support recommend an immediate onset of cardiac compressions in case of cardiac arrest followed by rescue breaths. Effective ventilation is often omitted due to fear of doing harm and fear of infectious diseases. In order to improve ventilation a pre-stage of an automatic respirator was developed for use by laypersons. METHODS: Fifty-two healthy volunteers were ventilated by means of a prototype respirator via a full-face mask in a pilot study...
December 4, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29191159/barriers-and-facilitating-factors-related-to-use-of-early-warning-score-among-acute-care-nurses-a-qualitative-study
#19
John Asger Petersen, Lars S Rasmussen, Susan Rydahl-Hansen
BACKGROUND: The early warning score (EWS) was developed to identify deteriorating patients early. It is a track-and-trigger system based on vital signs designed to direct appropriate clinical responses based on the seriousness and nature of the underlying condition. Despite its wide dissemination, serious adverse events still occur, often due to failure among staff on general wards to follow the EWS protocol. The purpose of the study was to determine barriers and facilitating factors related to three aspects of the EWS protocol: 1) adherence to monitoring frequency, 2) call for junior doctors to patients with an elevated EWS, and 3) call for the medical emergency team...
December 1, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29183276/the-effectiveness-of-prehospital-hypertonic-saline-for-hypotensive-trauma-patients-a-systematic-review-and-meta-analysis
#20
I E Blanchard, A Ahmad, K L Tang, P E Ronksley, D Lorenzetti, G Lazarenko, E S Lang, C J Doig, H T Stelfox
BACKGROUND: The optimal prehospital fluid for the treatment of hypotension is unknown. Hypertonic fluids may increase circulatory volume and mute the pro-inflammatory response of the body to injury and illness. The purpose of this systematic review is to determine whether in patients presenting with hypotension in the prehospital setting (population), the administration of hypertonic saline (intervention), compared to an isotonic fluid (control), improves survival to hospital discharge (outcome)...
November 28, 2017: BMC Emergency Medicine
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