European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Outpatient care in emergency departments: feasibility and comparison of three strategies for follow-up.
The outpatient population using the emergency department (ED) is increasing and so is the risk of not admitting people who need it. There is, thus, one important question: are the services delivered appropriate to the needs of these ED outpatients? Follow-up of non-admitted patients after a visit to the ED is a prerequisite for the evaluation of these health services. A multicentric follow-up study was thus performed in order to assess the possibility of contacting outpatients after a visit to the ED. ⋯ The success rate was 78.6%, 85.6% and 74% respectively (NS). In each strategy, 50% of patients were contacted at the first telephone call, 20% at the second telephone call and 10% by mail. Thus, in a group of outpatients who gave their consent to be called, the follow-up was found to be feasible with a high success rate whatever the time between the visit and the phone recall.
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The success of hospital-based flying squads in the management of out-of-hospital cardiac arrest has been well documented, but since the introduction of ambulance paramedics the need for such teams to deal with cardiac arrests has been questioned. We performed a 3-year retrospective study of non-traumatic arrests attended by Medic 1, the flying squad based at the Royal Infirmary of Edinburgh. ⋯ All but two of the survivors had return of spontaneous circulation prior to the arrival of Medic 1. Accident flying squads operating as a secondary response unit to victims of non-traumatic cardiac arrest are unlikely to have a significant effect upon overall survival.
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An intravascular access line for the administration of life support drugs and volume expanders may be particularly difficult, especially in very small premature babies. We report on the successful use of an intraosseous accessline in an 800 grams preterm infant for the administration of drugs and fluid. The use and technique of an intraosseous access is an important emergency alternative which may be lifesaving, even in very preterm babies, when other methods fail.