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Emergency Medicine Journal: EMJ

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https://read.qxmd.com/read/31292206/cross-sectional-evaluation-of-emergency-care-capacity-at-public-hospitals-in-zambia
#1
Chancy Chavula, Jennifer L Pigoga, Muhumpu Kafwamfwa, Lee A Wallis
OBJECTIVES: The last decade has seen rapid expansion of emergency care systems across Africa, although they remain underdeveloped. In Zambia, the Ministry of Health has taken interest in improving the situation and data are needed to appropriately guide system strengthening efforts. The Emergency Care Assessment Tool (ECAT) provides a context-specific means of measuring capacity of healthcare facilities in low- and middle-income countries. We evaluated Zambian public hospitals using the ECAT to inform resource-effective improvements to the nation's healthcare system...
July 10, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31292205/learning-from-mistakes-on-social-media
#2
Sarah Edwards, Damian Roland
BACKGROUND: Clinicians in the emergency care specialties often access information via social media (SM) to supplement their learning. The rapid and user-centred dissemination of information via SM speeds knowledge translation and means unnoticed errors may propagate quickly. East Midlands Emergency Medicine Educational Media is a UK web-based resource that produces emergency medicine-related learning materials. In October 2018, we inadvertently shared two sets of incorrect learning materials via SM because of a non-intentional mistake...
July 10, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31292204/-foamed-errors-does-the-opportunity-for-speedy-resolution-outweigh-the-risk-of-rapid-dissemination
#3
EDITORIAL
Simon Carley
No abstract text is available yet for this article.
July 10, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31273055/uk-s-initial-operational-response-and-specialist-operational-response-to-cbrn-and-hazmat-incidents-a-primer-on-decontamination-protocols-for-healthcare-professionals
#4
LETTER
Robert P Chilcott, Joanne Larner, Hazem Matar
No abstract text is available yet for this article.
July 4, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31273054/letter-in-response-to-uk-s-initial-operational-response-and-specialist-operational-response-to-cbrn-and-hazmat-incidents-a-primer-on-decontamination-protocols-for-healthcare-professionals
#5
LETTER
Clément Derkenne, Franck Calamai, Bertrand Prunet
No abstract text is available yet for this article.
July 4, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31253597/potential-added-value-of-the-new-emergency-care-dataset-to-ed-based-public-health-surveillance-in-england-an-initial-concept-analysis
#6
EDITORIAL
Roger Morbey, Helen Hughes, Gillian Smith, Kirsty Challen, Thomas C Hughes, Alex J Elliot
INTRODUCTION: For the London Olympic and Paralympic Games in 2012, a sentinel ED syndromic surveillance system was established to enhance public health surveillance by obtaining data from a selected network of EDs, focusing on London. In 2017, a new national standard Emergency Care Dataset was introduced, which enabled Public Health England (PHE) to initiate the expansion of their sentinel system to national coverage. Prior to this initiative, we estimated the added value, and potential additional resource use, of an expansion of the sentinel surveillance system...
June 28, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31239314/prevalence-and-correlates-of-domestic-violence-among-people-seeking-treatment-for-self-harm-data-from-a-regional-self-harm-register
#7
Tom Rollo Dalton, Duleeka Knipe, Gene Feder, Salena Williams, David Gunnell, Paul Moran
BACKGROUND: Previous research suggests that there is an association between domestic violence (DV) and self-harm (SH). Yet, the prevalence and clinical significance of DV among individuals presenting acutely to hospital with SH in the UK is unknown. OBJECTIVE: To measure the prevalence and correlates of DV among patients presenting to hospital with SH. METHODS: We conducted a cross-sectional study using registry data in order to describe the prevalence of DV within a UK population of people presenting to the emergency department (ED) with SH (n=1142)...
June 25, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31239315/impact-of-emergency-physician-experience-on-decision-making-in-patients-with-suspected-community-acquired-pneumonia-and-undergoing-systematic-thoracic-ct-scan
#8
Josselin Le Bel, Thierry Pelaccia, Patrick Ray, Charles Mayaud, Anne-Laure Brun, Pierre Hausfater, Enrique Casalino, Mikhael Benjoar, Yann-Erick Claessens, Xavier Duval
OBJECTIVES: To determine whether the impact of a thoracic CT scan on community-acquired pneumonia (CAP) diagnosis and patient management varies according to emergency physician's experience (≤10 vs >10 years). METHODS: Early thoracic CT Scan for Community-Acquired Pneumonia at the Emergency Department is an interventional study conducted from November 2011 to January 2013 in four French emergency departments, and included suspected patients with CAP. We analysed changes in emergency physician CAP diagnosis classification levels before and after CT scan; and their agreement with an adjudication committee...
June 24, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31230040/driving-stroke-quality-improvement-at-scale-in-eds-across-a-nationwide-network-of-hospitals-strategies-and-interventions
#9
Max Shpak, Kimberly Korwek, Zoltan Nadasdy, Anurekha Ramakrishnan, Matthew Cowperthwaite, Kristen Ankrom, Jon Jennings, Ashley Moody, Kevin Orndorff, Christopher Fanale
OBJECTIVES: Reducing the treatment time while increasing the proportion of eligible stroke patients who receive intravenous tissue plasminogen activator (tPA) has been a priority for many quality improvement efforts. Recent studies have primarily focused on identifying interventions that reduce door-to-needle (DTN) time, while comparatively little has been done to determine whether these interventions also improve tPA rates. METHODS: In order to investigate interventions related to process improvements, an electronic dashboard serving as a stroke performance tool was implemented to store and retrieve patient outcome data...
June 22, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31230039/paracetamol-versus-other-analgesia-in-adult-patients-with-minor-musculoskeletal-injuries-a-systematic-review
#10
REVIEW
Milan L Ridderikhof, Joppe Saanen, Helma Goddijn, Susan Van Dieren, Faridi Van Etten-Jamaludin, Philipp Lirk, J Carel Goslings, Markus W Hollmann
OBJECTIVES: Pain treatment in acute musculoskeletal injuries usually consists of paracetamol, non-steroidal antiinflammatory drugs (NSAIDs) or opioids. It would be beneficial to determine whether paracetamol is as effective as other analgesics. The objective of this study was to evaluate available evidence regarding efficacy of paracetamol in these patients. METHODS: Embase, MEDLINE, Cochrane and relevant trial registers were searched from inception to 14 February 2018 by two independent reviewers to detect all randomised studies with adult patients with acute minor musculoskeletal injuries treated with paracetamol as compared with other analgesics...
June 22, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31227526/reducing-repeat-paediatric-emergency-department-attendance-for-non-urgent-care-a-systematic-review-of-the-effectiveness-of-interventions
#11
REVIEW
Brenda Agyeiwaa Poku, Pippa Hemingway
OBJECTIVE: Non-urgent paediatric ED (PED) visits appear to contribute a large portion to the growing use of EDs globally. Several interventions have tried to curb repeated non-urgent attendances, but no systematic review of their effectiveness exists. This review examines the effectiveness of interventions designed to reduce subsequent non-urgent PED visits after a non-urgent attendance. METHOD: A systematic review design. A systematic search of four databases and key journals was conducted from their inception to November 2018...
June 21, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31221671/recognising-bias-in-studies-of-diagnostic-tests-part-2-interpreting-and-verifying-the-index-test
#12
EDITORIAL
Bory Kea, M Kennedy Hall, Ralph Wang
Multiple pitfalls can occur with the conduct and analysis of a study of diagnostic tests, resulting in biased accuracy. Our conceptual model includes three stages: patient selection, interpretation of the index test and disease verification. In part 2, we focus on (1) Interpretation bias (or workup bias): where the classification of an indeterminate index test result can bias the accuracy of a test or how lack of blinding can bias a subjective test result, and (2) Disease verification bias: where the index test result is incorporated into the gold standard or when the gold standard is applied only to a select population as the gold standard is an invasive test...
June 20, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31217182/possible-complications-of-martial-arts-technique
#13
Gamze Gokalp, Emel Berksoy, Sefika Bardak, Sule Demir, Gulsah Demir, Yuksel Bicilioglu, Neslihan Zengin
No abstract text is available yet for this article.
June 19, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31217181/first-responder-communication-in-cbrn-environments-fircom-cbrn-study
#14
Jan Schumacher, James Arlidge, Declan Dudley, Jennifer Van Ross, Francesca Garnham, Kate Prior
INTRODUCTION: Recent terror attacks and assassinations involving highly toxic chemical weapons have stressed the importance of sufficient respiratory protection of medical first responders and receivers. As full-face respirators cause perceptual-motor impairment, they not only impair vision but also significantly reduce speech intelligibility. The recent introduction of electronic voice projection units (VPUs), attached to a respirator, may improve communication while wearing personal respiratory protection...
June 19, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31217180/prehospital-tranexamic-acid-shortens-the-interval-to-administration-by-half-in-major-trauma-networks-a-service-evaluation
#15
Max E R Marsden, Andrea Rossetto, Charles A B Duffield, Thomas G D Woolley, William P Buxton, Sarah Steynberg, Rahul Bagga, Nigel R M Tai
INTRODUCTION: Tranexamic acid (TXA) reduces bleeding and mortality. Recent trials have demonstrated improved survival with shorter intervals to TXA administration. The aims of this service evaluation were to assess the interval from injury to TXA administration and describe the characteristics of patients who received TXA pre-hospital and in-hospital. METHODS: We reviewed Trauma and Audit Research Network records and local trauma registries to identify patients of any age that received TXA at all London Major Trauma Centres and Queen's Medical Centre, Nottingham, during 2017...
June 19, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31217179/outcomes-difference-in-non-invasive-ventilation-in-very-old-patients-with-acute-respiratory-failure-occult-gender-effect
#16
LETTER
Loredana Tibullo, Antonio Esquinas
No abstract text is available yet for this article.
June 19, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31217178/intramuscular-versus-oral-diclofenac-for-acute-pain-in-adults-with-acute-musculoskeletal-injuries-presenting-to-the-ed-setting-a-prospective-double-blind-double-dummy-randomised-controlled-trial
#17
Isma Qureshi, Sameer A Pathan, Raheel Sharfeen Qureshi, Stephen H Thomas
OBJECTIVE: The current study aimed to ascertain differences in early postmedication pain reduction in participants presenting with acute musculoskeletal injuries (MSI) to the ED receiving intramuscular (IM) versus per oral (PO) diclofenac. METHODS: This was a prospective, double-blinded, randomised controlled trial conducted between January and June 2018 at the ED of Hamad General Hospital in Doha, Qatar. Adults (18-65 years of age) presenting to the ED within 24 hours of an acute MSI, who had a triage pain score measured using numerical rating scale of at least five or above were enrolled in this trial...
June 19, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31171627/confirmed-cardiac-output-on-emergency-medical-services-arrival-as-confounding-by-indication-an-observational-study-of-prehospital-airway-management-in-patients-with-out-of-hospital-cardiac-arrest
#18
Atsushi Sakurai, Kosaku Kinoshita, Yukihiro Maeda, Yosuke Homma, Yoshio Tahara, Naohiro Yonemoto, Ken Nagao, Arino Yaguchi, Naoto Morimura
OBJECTIVES: Many registry studies on patients with out-of-hospital cardiac arrest (OHCA) have reported that conventional bag-valve-mask (BVM) ventilation is independently associated with favourable outcomes. This study aimed to compare the data of patients with OCHA with confirmed cardiac output on emergency medical services (EMS) arrival and consider the confounding factors in prehospital airway management studies. METHODS: This was a cohort study using the registry data for survivors after out-of hospital cardiac arrest in the Kanto region at 2012 in Japan (SOS-KANTO 2012)...
June 6, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31147349/the-association-of-paramedic-rapid-sequence-intubation-and-survival-in-out-of-hospital-stroke
#19
Pieter Francsois Fouche, Karen Smith, Paul Andrew Jennings, Malcolm Boyle, Stephen Bernard
INTRODUCTION: Ambulance transport of patients with stroke is common, with rapid sequence intubation (RSI) to secure the airway used regularly. Randomised controlled trial evidence exists to support the use of RSI in traumatic brain injuries (TBIs), but it is not clear whether the RSI evidence from TBI can be applied to the patient with stroke. To this end, we analysed a retrospective stroke dataset to compare survival of patients with RSI compared with patients that did not receive RSI...
May 30, 2019: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/31147348/who-s-afraid-of-emergency-physicians
#20
EDITORIAL
Daniele Orso
No abstract text is available yet for this article.
May 30, 2019: Emergency Medicine Journal: EMJ
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