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Emergency Medicine Journal: EMJ

Alison Cooper, Michelle Edwards, Janet Brandling, Andrew Carson-Stevens, Matthew Cooke, Freya Davies, Thomas Hughes, Katherine Morton, Aloysius Siriwardena, Sarah Voss, Jonathan Benger, Adrian Edwards
Primary care services in or alongside emergency departments look and function differently and are described using inconsistent terminology. Research to determine effectiveness of these models is hampered by outdated classification systems, limiting the opportunity for data synthesis to draw conclusions and inform decision-making and policy. We used findings from a literature review, a national survey of Type 1 emergency departments in England and Wales, staff interviews, other routine data sources and discussions from two stakeholder events to inform the taxonomy...
September 7, 2019: Emergency Medicine Journal: EMJ
Torben K Becker, Sarah S Gul, Scott A Cohen, Carolina B Maciel, Jacqueline Baron-Lee, Travis W Murphy, Teddy S Youn, Joseph A Tyndall, Clay Gibbons, Lizzy Hart, Carlos L Alviar-Restrepo
OBJECTIVE: Bystander cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest (OHCA) improves survival and neurological outcomes. Nonetheless, many OHCA patients do not receive bystander CPR during a witnessed arrest. Our aim was to identify potential barriers to bystander CPR. METHODS: Participants at CPR training events conducted in the USA between February and May 2018 answered a 14-question survey prior to training. Respondents were asked about their overall comfort level performing CPR, and about potential concerns specific to performing CPR on a middle-aged female, a geriatric male, and male and female adolescent patients...
August 31, 2019: Emergency Medicine Journal: EMJ
Stephanie Hill, Tom Jaconelli
No abstract text is available yet for this article.
August 28, 2019: Emergency Medicine Journal: EMJ
Richard Prendiville, Etimbuk Umana, Gloria Avalos, Brian McNicholl
BACKGROUND: Boarding in emergency departments (EDs) is a persistent problem worldwide. We hypothesised that patients sleeping while being boarded in EDs have worse self-rated sleep than those admitted from EDs who sleep on the ward. METHODS: Prospective cross-sectional study conducted at the University College Hospital, Galway between October and November 2016. Self-rated sleep in patients boarded in EDs from 23:00 to 07:00 was compared with those admitted to the ward before 23:00...
August 22, 2019: Emergency Medicine Journal: EMJ
Cheng-Yu Chien, Wei-Che Chien, Li-Heng Tsai, Shang-Li Tsai, Chen-Bin Chen, Chen-June Seak, Yu-Shao Chou, Matthew Ma, Yi-Ming Weng, Chip-Jin Ng, Cheng-Yu Lin, I-Shiang Tzeng, Chi-Chun Lin, Chien Hsiung Huang
OBJECTIVE: This study determined the impact of the caller's emotional state and cooperation on out-of-hospital cardiac arrest (OHCA) recognition and dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) performance metrics. METHODS: This was a retrospective study using data from November 2015 to October 2016 from the emergency medical service dispatching centre in northern Taiwan. Audio recordings of callers contacting the centre regarding adult patients with non-traumatic OHCA were reviewed...
August 22, 2019: Emergency Medicine Journal: EMJ
Emily Oliver
No abstract text is available yet for this article.
August 13, 2019: Emergency Medicine Journal: EMJ
Martín Otero-Agra, Roberto Barcala-Furelos, Iker Besada-Saavedra, Lucía Peixoto-Pino, Santiago Martínez-Isasi, Antonio Rodríguez-Núñez
OBJECTIVE: Gamification is a non-evaluation and competition-based training methodology with high emotional involvement. The goal of this study was to evaluate gamification methodology as compared with other existing methodologies when teaching cardiopulmonary resuscitation (CPR) to secondary school students. METHODS: 489 secondary school students from two high schools in Spain participated in this randomised-block quasi-experimental study in February 2018. The students were classified into different groups...
August 13, 2019: Emergency Medicine Journal: EMJ
Mary Dawood
The importance of end of life care (EoLC) for patients and their families is well documented, however, the skills and knowledge of emergency clinicians in delivering EoLC is not widely understood but it is clear from the existing literature that we fall short in delivering consistently good EoLC although there is recognition of the need to improve. This paper will acknowledge the challenges of delivering good EoLC in the emergency department (ED) but more importantly consider practical ways of improving EoLC in the ED in line with best practice guidelines on EoLC...
August 13, 2019: Emergency Medicine Journal: EMJ
Ffion Davies, Timothy J Coats
No abstract text is available yet for this article.
August 13, 2019: Emergency Medicine Journal: EMJ
Jamie A Mawhinney, Henry W Roscoe, George A J Stannard, Sophie R Tillman, Thomas D Cosker
OBJECTIVES: A major incident is any emergency that requires special arrangements by the emergency services and generally involves a large number of people. Recent such events in England have included the Manchester Arena bombing and the Grenfell Tower disaster. Hospitals are required by law to keep a major incident plan (MIP) outlining the response to such an event. In a survey conducted in 2006 we found a substantial knowledge gap among key individuals that would be expected to respond to the enactment of an MIP...
August 12, 2019: Emergency Medicine Journal: EMJ
Rachel Showstack
No abstract text is available yet for this article.
August 12, 2019: Emergency Medicine Journal: EMJ
Ivor Popovich, Nicolas Szecket, Art Nahill
BACKGROUND: Framing bias occurs when people make a decision based on the way the information is presented, as opposed to just on the facts themselves. How the diagnostician sees a problem may be strongly influenced by the way it is framed. Does framing bias result in clinically meaningful diagnostic error? METHODS: We created three hypothetical cases and asked consultants and registrars in Emergency Medicine and Internal Medicine to provide their differential diagnoses and investigations list...
August 8, 2019: Emergency Medicine Journal: EMJ
William Spencer, Jesse Smith, Patrick Date, Erik de Tonnerre, David McDonald Taylor
OBJECTIVE: Early warning scores (EWS) are used to predict patient outcomes. We aimed to determine which of 13 EWS, based largely on emergency department (ED) vital sign data, best predict important clinical outcomes. METHOD: We undertook a prospective cohort study in a metropolitan, tertiary-referral ED in Melbourne, Australia (February-April 2018). Patient demographics, vital signs and management data were collected while the patients were in the ED and EWS were calculated using each EWS criteria...
July 31, 2019: Emergency Medicine Journal: EMJ
Ziad Faramand, Stephanie O Frisch, Christian Martin-Gill, Parker Landis, Mohammad Alrawashdeh, Khaled A Al-Robaidi, Clifton W Callaway, Salah S Al-Zaiti
OBJECTIVES: Chest pain is among the leading causes for emergency medical services (EMS) activation. Acute myocardial infarction (MI) is not only one of the most critical aetiologies of chest pain, but also one of few conditions encountered by EMS that has been shown to follow a circadian pattern. Understanding the diurnal relationship between the inflow of chest pain patients and the likelihood of acute MI may inform prehospital and emergency department (ED) healthcare providers regarding the prediction, and hence prevention, of dire outcomes...
July 31, 2019: Emergency Medicine Journal: EMJ
Akshay Kumar, Dheeneshbabu Lakshminarayanan, Nitesh Joshi, Sonali Vaid, Sanjeev Bhoi, Ashok Deorari
BACKGROUND: Prolonged wait times prior to triage outside the emergency department (ED) were a major problem at our institution, compromising patient safety. Patients often waited for hours outside the ED in hot weather leading to exhaustion and clinical deterioration. The aim was to decrease the median waiting time to triage from 50 min outside ED for patients to <30 min over a 4-month period. METHODS: A quality improvement (QI) team was formed. Data on waiting time to triage were collected between 12 pm and 1 pm...
July 31, 2019: Emergency Medicine Journal: EMJ
Anna J Mackway-Jones, Kevin C Mackway-Jones
OBJECTIVE: This study aimed to investigate and collate the opinions of experts regarding the triage of patients in mental health crisis presenting to EDs. DESIGN: A three-round e-Delphi study was conducted between November 2017 and April 2018. The panel of 28 representative experts were drawn from six stakeholder groups. 23 of the panel were clinicians working in England, while 5 were international triage experts. RESULTS: Experts generated 173 statements in six topic areas in the first round...
July 31, 2019: Emergency Medicine Journal: EMJ
Alyssa F Harlow, Emily F Rothman, Sophia Dyer, Hanni Stoklosa
No abstract text is available yet for this article.
July 27, 2019: Emergency Medicine Journal: EMJ
Rebecca Wright, Bradley Hayward, Emmett Kistler, Victoria Vaughan Dickson, Corita Grudzen
OBJECTIVE: To explore the impact of an adapted goals-of-care communications skills workshop created for ED physicians from the physicians' perspective. METHODS: Semi-structured, one-on-one audio-recorded interviews lasting 30-60 min were conducted with twelve physicians who had completed the training workshop. Interviews explored the experience of undertaking the workshop, its impact on their clinical practice and their ability to teach new skills to other clinicians using learnt techniques...
July 26, 2019: Emergency Medicine Journal: EMJ
Bálint Bánfai, Attila Pandur, Bence Schiszler, Emese Pek, Balazs Radnai, Henrietta Csonka, József Betlehem
AIM: First aid education in early childhood can be an effective method to increase the number of trained bystanders. Our aim was to evaluate the long-term effects of a 3-day first aid programme for all primary school-age groups (7-14 years old). METHODS: This study was a 15-month follow-up of our previous investigation. Five-hundred and twenty-four primary school children were involved in this study. Measurements were made on the following topics: adult basic life support, using an automated external defibrillator (AED), handling an unconscious patient, managing bleeding and calling the ambulance...
July 20, 2019: Emergency Medicine Journal: EMJ
Jen Heng Pek, Yong-Kwang Gene Ong, En Ci Samuel Quek, Xun Yi Jasmine Feng, John Carson Allen, Shu-Ling Chong
BACKGROUND: Trauma team activation criteria have a variable performance in the paediatric population. We aimed to identify predictors for high-level resource utilisation during trauma resuscitation in the ED. METHODS: A retrospective study was conducted in the ED of a tertiary paediatric hospital. Patient data were collected from trauma surveillance registry and analysis was performed to identify significant predictors. We then assessed the sensitivity and specificity of proposed models with respect to observed patient outcomes...
July 20, 2019: Emergency Medicine Journal: EMJ
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