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Emergency Medicine Journal: EMJ

Shada A Rouhani, Henry Claude Eliacin, Marie Cassandre Edmond, Keegan A Checkett, Linda Rimpel, Regan H Marsh
BACKGROUND: In Haiti, like many low-income countries, traumatic injuries are leading causes of morbidity and mortality. Yet, little is known about the epidemiology of traumatic injuries in Haitian EDs. Improved understanding of injury patterns is necessary to strengthen emergency services and improve emergency provider education. METHODS: This was a retrospective cohort study of trauma patients at an academic hospital in central Haiti over 6 months. Visits were identified from the electronic medical record, and paper charts were manually reviewed...
March 15, 2019: Emergency Medicine Journal: EMJ
James Vassallo, Jason Smith
INTRODUCTION: A key principle in the effective management of major incidents is triage, the process of prioritising patients on the basis of their clinical acuity. In many countries including the UK, a two-stage approach to triage is practised, with primary triage at the scene followed by a more detailed assessment using a secondary triage process, the Triage Sort. To date, no studies have analysed the performance of the Triage Sort in the civilian setting. The primary aim of this study was to determine the performance of the Triage Sort at predicting the need for life-saving intervention (LSI)...
March 15, 2019: Emergency Medicine Journal: EMJ
Adrian A Boyle
No abstract text is available yet for this article.
March 15, 2019: Emergency Medicine Journal: EMJ
Lauren J Scott, Niamh M Redmond, Joanna Garrett, Penny Whiting, Kate Northstone, Anne Pullyblank
BACKGROUND: Early warning scores (EWS) were developed in acute hospital settings to improve recognition and response to patient deterioration. In 2012, the UK Royal College of Physicians developed the National Early Warning Score (NEWS) to standardise EWS across the NHS. Its use was also recommended outside acute hospital settings; however, there is limited information about NEWS in these settings. From March 2015, NEWS was implemented across the healthcare system in the West of England, with the aim that NEWS would be calculated for all patients prior to referral into acute care...
March 6, 2019: Emergency Medicine Journal: EMJ
Rainer Haseneder, Matthias Skrzypczak, Bernhard Haller, Stefan K Beckers, Julia Holch, Christina Wank, Eberhard Kochs, Christian M Schulz
INTRODUCTION: To increase the rate of bystander resuscitation, basic life support (BLS) training for schoolchildren is now recommended on a broad level. However, debate continues about the optimal teaching methods. In this study, we investigated the effects of a 90 min BLS training on female pupils' BLS knowledge and self-confidence and whether learning outcomes were influenced by the instructors' professional backgrounds or test-enhanced learning. METHODS: We conducted a cluster randomised, longitudinal trial in a girls' grammar school in Germany from 2013 to 2014...
February 16, 2019: Emergency Medicine Journal: EMJ
Jonathan David Green, Sean Ewings, Richard Wortham, Bronagh Walsh
BACKGROUND: A new pre-triage screening tool, Nature of Call (NoC), has been introduced into the telephone triage system of UK ambulance services which employ National Health Service Pathways (NHSP). Its function is to provide rapid recognition of patients who may need immediate ambulance dispatch for out-of-hospital cardiac arrest (OHCA) and withholding dispatch for other calls while further triage is undertaken. In this study, we evaluated the accuracy of NoC and NHSP in identifying patients with potentially treatable or imminent OHCA...
February 6, 2019: Emergency Medicine Journal: EMJ
Christopher A Smith, Richard D Hardern, Simon LeClerc, Richard J Howes
OBJECTIVE: To compare the mortality and morbidity of traumatically injured patients who received additional prehospital care by a doctor and critical care paramedic enhanced care team (ECT), with those solely treated by a paramedic non-ECT. METHODS: A retrospective analysis of Trauma Audit and Research Network (TARN) data and case note review of all severe trauma cases (Injury Severity Score ≥9) in North East England from 1 January 2014 to 1 December 2017 who were treated by the North East Ambulance Service, the Great North Air Ambulance Service or both...
January 24, 2019: Emergency Medicine Journal: EMJ
Matthew R Edmunds, Anjana S Haridas, Daniel S Morris, Kasyap Jamalapuram
INTRODUCTION: Acute retrobulbar haemorrhage (RBH) with orbital compartment syndrome is a sight-threatening ophthalmic emergency requiring treatment with lateral canthotomy and cantholysis (LC/C). However, such cases may present to non-ophthalmic emergency departments (ED) out-of-hours, when specialist intervention is not readily available. We completed a survey of ED physicians to explore experiences of RBH and confidence in undertaking LC/C. METHODS: From February to April 2018, an online survey was sent to ED physicians of all training grades in seven UK locations...
January 10, 2019: Emergency Medicine Journal: EMJ
Edmond A Hooker, William J Faulkner, Lisa D Kelly, Robert C Whitford
OBJECTIVE: The Wood's lamp, a handheld instrument that uses long-wave ultraviolet (UV) light with magnification of 2-3 times, is commonly used by non-ophthalmologists for examining patients with eye complaints. The goal of current research was to determine the sensitivity and specificity of the Wood's lamp for common eye abnormalities. STUDY DESIGN: We examined a convenience sample of patients, 18 years of age and older, who presented for eye complaints to an urgent clinic of a large ophthalmology practice...
January 10, 2019: Emergency Medicine Journal: EMJ
Maria Clara Magalhães-Barbosa, Jaqueline Rodrigues Robaina, Arnaldo Prata-Barbosa, Claudia de Souza Lopes
OBJECTIVE: To present a systematic review on the reliability of triage systems for paediatric emergency care. METHODS: A search of MEDLINE, Cochrane Library, Latin American and Caribbean Health Sciences Literature, Scientific Electronic Library Online, Nursing Database Index and Spanish Health Sciences Bibliographic Index for articles in English, French, Portuguese or Spanish was conducted to identify reliability studies of five-level triage systems for patients aged 0-18 years published up to April 2018...
January 10, 2019: Emergency Medicine Journal: EMJ
Lisa M Kodadek, Susan Peterson, Ryan Y Shields, Danielle German, Anju Ranjit, Claire Snyder, Eric Schneider, Brandyn D Lau, Adil H Haider
BACKGROUND: In the USA, The Joint Commission and Institute of Medicine have called for collection of patient sexual orientation (SO) and gender identity (GI) information in healthcare. In a recent study, we reported that ED clinicians believe patients will refuse to provide this information; however, very few patients say they would refuse to provide SO/GI. As part of this study, we interviewed patients and providers regarding the importance of collecting this information. While these interviews were briefly summarised in our prior report, the qualitative data warranted a more thorough analysis and exposition to explore provider and patient views as well as risks and benefits of collecting SO/GI...
January 10, 2019: Emergency Medicine Journal: EMJ
Kharmene L Sunga, Dara Kass
Female physicians in the USA achieve associate and full professor rank at numbers disparate to their representation within emergency medicine (EM). The authors describe a novel curriculum aimed at developing women speakers as a step on the journey towards academic recognition. In this pilot programme, four female physicians at a single academic emergency department participated in a year-long Speaker Development Programme (SDP), and all presented in at least one national EM conference at SDP completion. Participants reported improved speaking skills, confidence and drive to present externally...
January 10, 2019: Emergency Medicine Journal: EMJ
Wei-Jing Lee, Chien-Chin Hsu
No abstract text is available yet for this article.
March 2019: Emergency Medicine Journal: EMJ
Antonio J Martín-Jiménez, Miguel Ángel Cornejo-Saucedo, Daniel García-Gil
No abstract text is available yet for this article.
March 2019: Emergency Medicine Journal: EMJ
Laura Simone, Mark D Lyttle, Damian Roland, Derek Stephens, Suzanne Schuh
BACKGROUND: Serious bacterial infections in young infants with bronchiolitis are rare. Febrile infants <1 month old with bronchiolitis often receive a lumbar puncture (LP), despite limited data for this practice and lack of clinical practice guidelines for this population. The primary objective was to investigate practice patterns in performance of LPs in the ED management of febrile infants aged ≤30 days with bronchiolitis. METHODS: A cross-sectional survey of two national paediatric emergency research networks (PediatricEmergency Research Canada (PERC) and the PediatricEmergency Research UK/Ireland (PERUKI)) was conducted January to November 2017 using a modified Dillman technique...
March 2019: Emergency Medicine Journal: EMJ
Heidi Storm Vikke, Svend Vittinghus, Matthias Giebner, Hans Jørn Kolmos, Karen Smith, Maaret Castrén, Veronica Lindström
INTRODUCTION: Healthcare-associated infection caused by insufficient hygiene is associated with mortality, economic burden, and suffering for the patient. Emergency medical service (EMS) providers encounter many patients in different surroundings and are thus at risk of posing a source of microbial transmission. Hand hygiene (HH), a proven infection control intervention, has rarely been studied in the EMS. METHODS: A multicentre prospective observational study was conducted from December 2016 to May 2017 in ambulance services from Finland, Sweden, Australia and Denmark...
March 2019: Emergency Medicine Journal: EMJ
Jennifer A Newberry, Corey B Bills, Elizabeth A Pirrotta, Michele Barry, Govindaraju Venkata Ramana Rao, Swaminatha V Mahadevan, Matthew C Strehlow
BACKGROUND: Low/middle-income countries carry a disproportionate burden of the morbidity and mortality from thermal burns. Nearly 70% of burn deaths worldwide are from thermal burns in India. Delays to medical care are commonplace and an important predictor of outcomes. We sought to understand the role of emergency medical services (EMS) as part of the healthcare infrastructure for thermal burns in India. METHODS: We conducted a prospective observational study of patients using EMS for thermal burns across five Indian states from May to August 2015...
March 2019: Emergency Medicine Journal: EMJ
Michelle Seiler, Georg Staubli, Markus A Landolt
OBJECTIVE: Nitrous oxide 70% (N2 O 70%) is an excellent medication for procedural analgosedation (PAS), yet the limit of its analgesic power remains uncertain; therefore, a combination with intranasal fentanyl (INF) was suggested. However, this combination seems to result in a higher rate of vomiting and deeper sedation. This study aimed at assessing the analgesic efficacy, sedation depth and rate of adverse events of PAS with N2 O 70% with and without INF. METHODS: Patients aged 2-16 years who qualified for PAS with N2 O 70% were randomly assigned to receive either INF or placebo prior to N2 O inhalation in this randomised, double-blind study, which was performed in a tertiary children's hospital ED between September 2015 and October 2017...
March 2019: Emergency Medicine Journal: EMJ
Jason Smith, James Vassallo, Mark D Lyttle
No abstract text is available yet for this article.
March 2019: Emergency Medicine Journal: EMJ
Aidan Baron
No abstract text is available yet for this article.
March 2019: Emergency Medicine Journal: EMJ
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