European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The Trondheim region's (315 km2, population 154,000) emergency medical service (EMS) provides advanced cardiac life support (ACLS) with combined paramedic and physician response. This EMS system is commonly employed in Norway, yet no population based study of outcome in cardiac arrest has been published to date. This retrospective study reports incidence and outcome from every attempted out-of-hospital cardiopulmonary resuscitation (CPR) during 1990 through 1994 according to the Utstein template. ⋯ Most patients made a favourable cerebral outcome, although nine were severely disabled. This is the first population-based Norwegian study of outcome from out-of-hospital cardiac arrest in this combined paramedic/physician staffed EMS. Incidence, survival and neurological outcome are comparable with results obtained in other EMS systems.
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Review Comparative Study
Is there a gender difference in aetiology of chest pain and symptoms associated with acute myocardial infarction?
Many previous studies have shown that there is a gender difference in terms of the use of diagnostic procedures and the treatment of patients with chest pain. The mechanisms behind these observations are less well described. This survey describes gender differences in the aetiology of chest pain and symptoms associated with acute myocardial infarction (AMI). ⋯ In terms of electrocardiographic changes, women seem to have less marked ST deviations than men. However, we do not believe that these differences between women and men are substantial enough and, as a result, we do not recommend that the initial medical care of patients seeking medical attention with chest pain or other symptoms raising a suspicion of AMI should be differentiated with regard to gender. The differences described here might partly explain the prolonged delay until hospital admission in women suffering from AMI.
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Comparative Study
How good are accident and emergency doctors in the evaluation of psychiatric patients?
The aim of this study was to find out the agreement between psychiatrists and emergency department (ED) doctors in the diagnosis and treatment of psychiatric emergencies. All patients presenting with a psychiatric complaint and who were subsequently referred to the psychiatrist were included. A standard form was used to collect demographic data, provisional diagnoses and initial treatment by ED doctors, diagnoses by psychiatrists, and compatibility of ED diagnoses and treatment as judged by consulting psychiatrists. ⋯ The agreements between psychiatrists and ED doctors in diagnosis and treatment were 61.4% and 89.5% respectively. Schizophrenia and bipolar disorders were least likely to be mis-classified. It is concluded that ED doctors were deficient in the diagnosis of psychiatric conditions especially in the less common diagnostic categories.