International emergency nursing
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Review
The patient experience in the emergency department: A systematic synthesis of qualitative research.
The aim of this study was to systematically review qualitative literature published between 1990 and 2006 exploring the patient experience within the emergency department (ED) with the intent of describing what factors influence the patient experience. Twelve articles were retrieved following combination of key words using five databases. ⋯ This was in contrast to the culture of the ED which emphasised "medical-technical" skill and efficiency. Satisfaction studies need to understand many factors and influences, qualitative methodologies have the ability to do so.
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In the previous part of this four part series on thoracic trauma the anatomy and physiology of the thorax, assessment and initial nursing interventions, imaging and adjuncts to diagnosis were discussed. Part 2 describes specific chest wall and lung injuries, types of pneumothoraces and their diagnosis and management. Sections 3 and 4 will examine other types of thoracic injuries and their management, such as trauma to the diaphragm and heart. The final part provides a brief but concise overview of neck anatomy, trauma and management.
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This prospective study compared pre- and post-class performance in basic life support (BLS) on a recording manikin in a convenience sample of 34 health care workers undertaking a two-hour class provided by a hospital resuscitation department teaching the 2005 Resuscitation Council (UK) guidelines. On completion of training there were significant improvements in the proportion of subjects correctly performing a safe approach (14/34 vs. 25/33, 95%CI +11 to +55%, p=0.004), checking for response (17/34 vs. 24/32, 95%CI +1 to +46%, p=0.029), shouting for help (18/34 vs. 28/32, 95%CI +13 to +54%, p=0.002), opening the airway (6/34 vs. 26/32, 95%CI +42 to +79%, p<0.001), checking for breathing (9/34 vs. 27/32, 95%CI +35 to +74%, p<0.001), calling a cardiac arrest team (1/34 vs. 24/32, 95%CI +53 to +85%, p<0.001), and providing the correct compression to breath ratio (11/34 vs. 20/34, +3 to +48%, p=0.033). The median number of correct chest compressions increased from 3 to 41 (p<0.001) with improvements in adequate depth (median depth 36 vs. 40mm, p=0.006), although the compression rate was too fast before training and increased afterwards (median 123 vs. 147, p<0.001). Ventilation performance could not be measured accurately as the manikin was calibrated incorrectly by the manufacturers.
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Severe accidental hypothermia mainly affects victims of outdoor accidents. However, hypothermia can also occur in non-traumatized indoor patients. The aim of this study was to examine the occurrence of hypothermia obtained at the scene of the rescue in patients classified as priority 1 cases during two three-month periods in southern Sweden. ⋯ The environment temperature was measured on arrival according to the location where the rescue occurred and core temperatures (tympanic membrane) of patients were measured in connection with the monitoring in the ambulance before departure and at the time of arrival to the emergency room at the hospital. This study demonstrated that the only group that shows body core temperature below 36 degrees C, was the outdoor intoxication-group during the winter-period (35.7+/-1.3 degrees C). We conclude that intoxicated patients are at higher risk for hypothermia than minor trauma patients.