Daniel Horner, John O'Rourke, James Collins, Daniel Darbyshire, Fiona Lecky
No abstract text is available yet for this article.
January 15, 2021: Emergency Medicine Journal: EMJ
Lynsey Flowerdew, Michelle Tipping
INTRODUCTION: According to safety theory, frontline staff are often best informed to identify problems that threaten safety in their workplace. Surveying emergency department (ED) staff is a straightforward method for investigating risks, identifying solutions and evaluating interventions. This study's aim was to validate an ED safety questionnaire specifically for use in the UK and provide an overview of safety culture and risks. METHODS: An ED safety questionnaire developed in the USA was modified then validated using 33 RCEM (Royal College of Emergency Medicine) patient safety leads (calculating content validity index)...
January 15, 2021: Emergency Medicine Journal: EMJ
Arshia P Javidan, Kim Hansen, Ian Higginson, Peter Jones, Eddy Lang
OBJECTIVE: To develop comprehensive guidance that captures international impacts, causes and solutions related to emergency department (ED) crowding and access block. METHODS: Emergency physicians representing 15 countries from all International Federation of Emergency Medicine (IFEM) regions composed the Task Force. Monthly meetings were held via video-conferencing software to achieve consensus for report content. The report was submitted and approved by the IFEM Board on June 1, 2020...
January 13, 2021: Emergency Medicine Journal: EMJ
Max Sugarman, Blair Graham, Sarah Langston, Pam Nelmes, John Matthews
Hot debriefing (HoD) describes a structured team-based discussion which may be initiated following a significant event. Benefits may include improved teamwork, staff well-being and identification of learning opportunities. Existing literature indicates that while staff value HoD following significant events, it is infrequently undertaken in practice. Internationally, several frameworks for HoD have been developed, although none are widely adopted for use in the ED. A quality improvement project was conducted to introduce HoD into a single UK ED in North West England, between January and March 2019...
January 13, 2021: Emergency Medicine Journal: EMJ
Gabin Mbanjumucyo, Adam Aluisio, Giles N Cattermole
BACKGROUND: Formalised emergency departments (ED) are in early development in sub-Saharan Africa and there are limited data on emergency airway management in those settings. This study evaluates characteristics and outcomes of ED endotracheal intubation, as well as risk factors for mortality, at a teaching hospital in Rwanda. METHODS: This was a prospective observational study of consecutive patients requiring endotracheal intubation at the University Teaching Hospital of Kigali ED conducted between 1 January and 31 December 2017...
January 12, 2021: Emergency Medicine Journal: EMJ
Ryan Barnicle, Alexander Bracey, Bassam Zahid, Alexandra Davic, Scott Weingart
Our ED-intensive care unit has instituted a new protocol meant to maximise the safety of physicians, nurses and respiratory therapists involved with endotracheal intubation of patients known or suspected of being infected with the novel SARS-CoV-2. The level of detail involved with this checklist is a deviation from standard intubation practices and is likely unfamiliar to most emergency physicians. However, the two-person system used in our department removes the cognitive burden such complexity would otherwise demand and minimises the number of participants that would typically be exposed during endotracheal intubation...
January 5, 2021: Emergency Medicine Journal: EMJ
Alice Cameron, Serryth Dominic Colbert, Alisdair Macleod, Harinderjit S Gill
INTRODUCTION: UK national newspapers have reported cases of children (and adults) who have got their tongue trapped in a Disney travel mug lid, causing extreme distress to the patients, their parents and ED staff. Potential risks include oral endotracheal intubation necessitating emergency tracheostomy to secure the airway, tongue necrosis and dental trauma. Although Disney has withdrawn their original mug from the global market, the same dangers can occur with other internationally available brands...
January 4, 2021: Emergency Medicine Journal: EMJ
William Shyy, Roneesha Knight
No abstract text is available yet for this article.
December 21, 2020: Emergency Medicine Journal: EMJ
Bart G J Candel, Selma M M Vaes, Egid M van Bree, Sophie M A Groenen, Floor Derkx, Lisette A A Mignot, Bas de Groot
BACKGROUND: Personal protective equipment (PPE) used by healthcare workers was scarce during the COVID-19 pandemic . The aim of this study was to assess whether telemedicine (using iPads) reduced PPE use in emergency department (ED) patients who were treated in contact isolation, and whether telemedicine had a positive effect on patient anxiety and satisfaction. METHODS: We conducted a prospective single centre before-and-after study including ED patients ≥18 years who were treated in contact isolation...
December 21, 2020: Emergency Medicine Journal: EMJ
Silvia Bressan, Liviana Da Dalt, Miriam Chamorro, Raquel Abarca, Danila Azzolina, Dario Gregori, Fabio Sereni, Giovanni Montini, Gianni Tognoni
BACKGROUND: We aim to describe the characteristics and outcomes of the severe spectrum of paediatric emergency visits using a multi-site registry developed as part of an international cooperation project. METHODS: This observational registry-based study presented descriptive statistics of clinical and outcome data on urgent-emergency paediatric visits from 7 Nicaraguan hospitals, including the national referral paediatric hospital, between January and December 2017...
December 21, 2020: Emergency Medicine Journal: EMJ
Viola Löflath, Eva-Maria Hau, Daniel Garcia, Steffen Berger, Ruth Löllgen
INTRODUCTION: Patient numbers in paediatric emergency departments (PED) are steadily increasing. Parental perception of waiting time and reasons for attending a PED with non-emergencies have been investigated in the UK, Australia, Korea, Canada and the USA. We sought to examine which factors influence parental satisfaction with waiting time in a tertiary Swiss PED and whether these differed from other countries. METHODS: Paper surveys were administered to parents of children presenting to our interdisciplinary PED from February to May 2015...
December 21, 2020: Emergency Medicine Journal: EMJ
Junteng Zhou, Qi Zhang, Xiaojing Liu
No abstract text is available yet for this article.
December 21, 2020: Emergency Medicine Journal: EMJ
Emily Neill, Nida Felicija Degesys, Sally Graglia
No abstract text is available yet for this article.
December 21, 2020: Emergency Medicine Journal: EMJ
William Robert Kitchen
No abstract text is available yet for this article.
December 21, 2020: Emergency Medicine Journal: EMJ
David Alao
No abstract text is available yet for this article.
December 21, 2020: Emergency Medicine Journal: EMJ
Julien Blais Lécuyer, Éric Mercier, Pier-Alexandre Tardif, Patrick M Archambault, Jean-Marc Chauny, Simon Berthelot, Jérôme Frenette, Jeff Perry, Ian Stiell, Marcel Émond, Jacques Lee, Eddy Lang, Andrew McRae, Valérie Boucher, Natalie Le Sage
BACKGROUND: Clinical assessment of patients with mild traumatic brain injury (mTBI) is challenging and overuse of head CT in the ED is a major problem. Several studies have attempted to reduce unnecessary head CTs following a mTBI by identifying new tools aiming to predict intracranial bleeding. Higher levels of S100B protein have been associated with intracranial haemorrhage following a mTBI in previous literature. The main objective of this study is to assess whether plasma S100B protein level is associated with clinically significant brain injury and could be used to reduce the number of head CT post-mTBI...
December 18, 2020: Emergency Medicine Journal: EMJ
Wolf E Hautz, Aristomenis Exadaktylos, Thomas C Sauter
Health systems face major challenges during the COVID-19 pandemic with new information and challenges emerging daily and frequently changing guidelines. Online forward triage tools (OFTTs) provide useful information, direct patients and free physician resources.We implemented an OFTT targeted at the current pandemic, adapted the content and goals and assessed its effects. The OFTT was implemented on 2 March 2020 and modified regularly based on the revised testing criteria issued by the Swiss Federal Office of Public Health...
December 11, 2020: Emergency Medicine Journal: EMJ
Fiona Marie Burton, David John Lowe, Jonathan Millar, Alasdair R Corfield, Malcolm J Watson, Malcolm A B Sim
BACKGROUND: Procedural sedation is a core skill of the emergency physician. Bolus administration of propofol is widely used in UK EDs. Titrated to an end point of sedation, it has a rapid effect but has been associated with adverse incidents. The use of a target-controlled infusion (TCI) of propofol is not routine but may reduce the incidence of adverse incidents.The primary aims of this single-arm feasibility study were patient satisfaction and to establish recruitment rates for a randomised controlled trial comparing propofol TCI to bolus administration...
December 9, 2020: Emergency Medicine Journal: EMJ
Lucy Beasant, Edward Carlton, Gareth Williams, Jonathan Benger, Jenny Ingram
BACKGROUND: Rapid discharge strategies for patients with low-risk chest pain using high-sensitivity troponin assays have been extensively evaluated. The adherence to, and acceptability of such strategies, has largely been explored using quantitative data. The aims of this integrated qualitative study were to explore the acceptability of the limit of detection and ECG discharge strategy (LoDED) to patients and health professionals, and to refine a discharge information leaflet for patients with low-risk chest pain...
December 9, 2020: Emergency Medicine Journal: EMJ
Adrian Perera, Hatem Alkouri, Toby Fogg, John Vassiliadis, John Mackenzie, Yashvi Wimalasena
Apnoeic oxygenation (ApOx) has been demonstrated to reduce the incidence of desaturation, although evidence of benefit has been conflicting depending on the technique used. The aim of this study was to compare the incidence of desaturation between patients who received ApOx via conventional nasal cannula (NC) and those who did not, using a large, multicentre airway registry. METHODS: This study is an analysis of 24 months of prospectively collected data in the Australia and New Zealand Emergency Department Airway Registry (June 2013-June 2015)...
December 9, 2020: Emergency Medicine Journal: EMJ
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