Emergency Medicine Journal: EMJ

Federico Germini, Maura Marcucci, Marta Fedele, Maria Giulia Galli, Tevin Heath, Lawrence Mbuagbaw, Valentina Salvatori, Giacomo Veronese, Andrew Worster, Lehana Thabane
OBJECTIVE: We investigated the association between the publication of the Consolidated Standards of Reporting Trials extension for abstracts (CONSORT-EA) and other variables of interest on the quality of reporting of abstracts of randomised controlled trials (RCTs) published in emergency medicine (EM) journals. METHODS: We performed a survey of the literature, comparing the quality of reporting before (2005-2007) with after (2014-2015) the publication of the dedicated CONSORT-EA in 2008...
November 6, 2019: Emergency Medicine Journal: EMJ
Daniel Horner, Steve Goodacre, Abdullah Pandor, Timothy Nokes, Jonathan Keenan, Beverley Hunt, Sarah Davis, John W Stevens, Kerstin Hogg
Venous thromboembolic disease is a major global cause of morbidity and mortality. An estimated 10 million episodes are diagnosed yearly; over half of these episodes are provoked by hospital admission/procedures and result in significant loss of disability adjusted life years. Temporary lower limb immobilisation after injury is a significant contributor to the overall burden of venous thromboembolism (VTE). Existing evidence suggests that pharmacological prophylaxis could reduce overall VTE event rates in these patients, but the proportional reduction of symptomatic events remains unclear...
November 6, 2019: Emergency Medicine Journal: EMJ
Ellen J Weber, Richard Body
No abstract text is available yet for this article.
November 6, 2019: Emergency Medicine Journal: EMJ
Charles Reynard, Govind Oliver, Tajek Hassan, Richard Body
No abstract text is available yet for this article.
November 4, 2019: Emergency Medicine Journal: EMJ
Eoin O'Mahony, Éidín Ní Shé, Jade Bailey, Hasheem Mannan, Eilish McAuliffe, John Ryan, John Cronin, Marie Therese Cooney
OBJECTIVES: This study aimed to assess the pattern of use of EDs, factors contributing to the visits, geographical distribution and outcomes in people aged 65 years or older to a large hospital in Dublin. METHODS: A retrospective analysis of 2 years of data from an urban university teaching hospital ED in the southern part of Dublin was reviewed for the period 2014-2015 (n=103 022) to capture the records of attenders. All ED presentations by individuals 65 years and older were extracted for analysis...
November 2, 2019: Emergency Medicine Journal: EMJ
Yutaka Kondo, Hiroyuki Ohbe, Hideo Yasunaga, Hiroshi Tanaka
OBJECTIVE: Focused assessment with sonography in trauma (FAST) examination is a widely known initial evaluation for patients with trauma. However, it remains unclear whether FAST contributes to patient survival in patients with haemodynamically stable trauma. In this study, we compared in-hospital mortality and length of stay between patients undergoing initial FAST vs initial CT for haemodynamically stable torso trauma. METHODS: This was a retrospective cohort study using data from 264 major emergency hospitals in the Japan Trauma Data Bank between 2004 and 2016...
October 30, 2019: Emergency Medicine Journal: EMJ
Larry Han, Jason Fine, Susan M Robinson, Adrian A Boyle, Michael Freeman, Stefan Scholtes
OBJECTIVE: Admission to hospital over a weekend is associated with increased mortality, but the underlying causes of the weekend effect are poorly understood. We explore to what extent differences in emergency department (ED) admission and discharge processes, severity of illness and the seniority of the treating physician explain the weekend effect. METHODS: We analysed linked ED attendances to hospital admissions to Cambridge University Hospital over a 7-year period from 1 January 2007 to 31 December 2013, with 30-day in-hospital death as the primary outcome and discharge as a competing risk...
October 30, 2019: Emergency Medicine Journal: EMJ
Katherine Henderson
No abstract text is available yet for this article.
October 30, 2019: Emergency Medicine Journal: EMJ
Sarah Hui Wen Yao, Gene Yong-Kwang Ong, Ian K Maconochie, Khai Pin Lee, Shu-Ling Chong
OBJECTIVE: Febrile infants≤3 months old constitute a vulnerable group at risk of serious infections (SI). We aimed to (1) study the test performance of two clinical assessment tools-the National Institute for Health and Care Excellence (NICE) Traffic Light System and Severity Index Score (SIS) in predicting SI among all febrile young infants and (2) evaluate the performance of three low-risk criteria-the Rochester Criteria (RC), Philadelphia Criteria (PC) and Boston Criteria (BC) among well-looking febrile infants...
October 25, 2019: Emergency Medicine Journal: EMJ
Ahmed Aljabri, Stephen Perona, Mohannad Alshibani, Moteb Khobrani, Daniel Jarrell, Asad E Patanwala
BACKGROUND: Dextrose is commonly administered with insulin during the management of hyperkalaemia to avoid hypoglycaemia. Previous research has evaluated the incidence of hypoglycaemia; however, none have reported the extent of blood glucose reduction after this regimen. The aim of this study was to better characterise the changes in blood glucose and to identify patients who may have an increased response to insulin. METHODS: This was a multicentre retrospective study evaluating adult patients who received a regimen of 10 units of intravenous regular insulin plus 25 g of intravenous dextrose to manage hyperkalaemia between January 2014 and September 2016...
October 25, 2019: Emergency Medicine Journal: EMJ
S M Osama Bin Abdullah, Rune Husås Sørensen, Ram Benny Christian Dessau, Saifullah Muhammed Rafid Us Sattar, Lothar Wiese, Finn Erland Nielsen
BACKGROUND: Few prospective studies have evaluated the quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) criteria in emergency department (ED)settings. The aim of this study was to determine the prognostic accuracy of qSOFA compared with systemic inflammatory response syndrome (SIRS) in predicting the 28-day mortality of infected patients admitted to an ED. METHODS: A prospective observational cohort study of all adult (≥18 years) infected patients admitted to the ED of Slagelse Hospital, Denmark, was conducted from 1 October 2017 to 31 March 2018...
October 25, 2019: Emergency Medicine Journal: EMJ
James David van Oppen, Lisa Keillor, Áine Mitchell, Timothy John Coats, Simon Paul Conroy
OBJECTIVES: To evaluate the expectations and preferred outcomes from emergency care among older people or their caregivers. METHODS: A review protocol was registered. Medline, Embase, CINAHL, PsychInfo, BNI, AgeInfo and the Cochrane Database of Systematic Reviews were searched in their full date ranges to September 2018. Included articles were hand-searched for further citations. Citations were screened for (1) older people aged over 65 years, (2) ED settings and (3) reporting expectations or preferred outcomes for emergency care (as opposed to experience or satisfaction)...
October 24, 2019: Emergency Medicine Journal: EMJ
Leonoor Neline Tess Oerlemans, Wierd P Zijlstra, Heleen Lameijer, Constant W Coolsma
Clinical introductionA 68-year-old man, with known spasticity and a total left hip arthroplasty (THA) performed 6 years ago, was brought to our ED after falling down the stairs. Laying on the stretcher, his left leg was internally rotated and in hyperflexion. An X-ray of the left hip was performed. The diagnosis of posterior hip dislocation was made (figure 1). The patient received sedation and analgesia with 75 mg propofol and 9 mg esketamine intravenously, and a closed reduction procedure was attempted using manual flexion, adduction, traction and internal rotation...
October 18, 2019: Emergency Medicine Journal: EMJ
Kenneth A Michelson, Lillian C Buchhalter, Richard G Bachur, Prashant Mahajan, Michael C Monuteaux, Jonathan A Finkelstein
BACKGROUND: Delayed diagnoses of serious emergency conditions can lead to morbidity in children, but are challenging to identify and measure. We developed and piloted an automated tool for identifying delayed diagnosis of two serious conditions commonly seen in the ED using administrative data. METHODS: We identified cases with a final diagnosis of appendicitis or sepsis in a freestanding children's hospital from 2008 to 2018, with any hospital ED encounter within the preceding 7 days...
October 9, 2019: Emergency Medicine Journal: EMJ
Emma Knowles, Neil Shephard, Tony Stone, Suzanne M Mason, Jon Nicholl
BACKGROUND: In England the demand for emergency care is increasing, while there is also a staffing shortage. This has implications for quality of care and patient safety. One solution may be to concentrate resources on fewer sites by closing or downgrading emergency departments (EDs). Our aim was to quantify the impact of such reorganisation on population mortality. METHODS: We undertook a controlled interrupted time series analysis to detect the impact of closing or downgrading five EDs, which occurred due to concerns regarding sustainability...
October 7, 2019: Emergency Medicine Journal: EMJ
Clifford Mann
No abstract text is available yet for this article.
October 7, 2019: Emergency Medicine Journal: EMJ
Alan A Garner, Nicholas Bennett, Andrew Weatherall, Anna Lee
OBJECTIVES: Paediatric intubation is a high-risk procedure for ground emergency medical services (GEMS). Physician-staffed helicopter EMS (PS-HEMS) may bring additional skills, drugs and equipment to the scene including advanced airway management beyond the scope of GEMS even in urban areas with short transport times. This study aimed to evaluate prehospital paediatric intubation performed by a PS-HEMS when dispatched to assist GEMS in a large urban area and examine how often PS-HEMS provided airway intervention that was not or could not be provided by GEMS...
October 3, 2019: Emergency Medicine Journal: EMJ
Robert Winter
No abstract text is available yet for this article.
October 3, 2019: Emergency Medicine Journal: EMJ
Jaimi H Greenslade, Marianne Wallis, Amy N B Johnston, Eric Carlström, Daniel B Wilhelms, Julia Crilly
BACKGROUND: The ED Stressor Scale outlines 15 stressors that are of importance for ED staff. Limited research has identified how commonly such stressors occur, or whether such factors are perceived with similar importance across different hospitals. This study sought to examine the frequency or perceived severity of these 15 stressors using a multicentre cohort of emergency clinicians (nurses and physicians) in EDs in two countries (Australia and Sweden). METHOD: This was a cross-sectional survey of staff working in eight hospitals in Australia and Sweden...
September 24, 2019: Emergency Medicine Journal: EMJ
Adam Parks, Debra Eagles, Yipeng Ge, Ian G Stiell, Warren J Cheung
BACKGROUND: Geriatric patients commonly present to the ED after a fall. Recent evidence suggests that ED physicians are poorly adherent to published ED-specific geriatric fall guidelines. This study applied a theoretical domains framework (TDF) approach to systematically investigate barriers and enablers in the provision of guideline-based care to ED geriatric fall patients. METHODS: From June to September 2017, semistructured interviews of staff ED physicians practising in Ontario, Canada, were conducted and analysed...
September 24, 2019: Emergency Medicine Journal: EMJ
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