European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The objective of this study was to assess patients' attitudes towards medical students in the accident and emergency department. Patients attending a university department of accident and emergency were given a questionnaire asking about their attitudes to medical students. ⋯ No patients reported feeling pressurized to accept this proposal. It is concluded that most patients attending the emergency department had favourable attitudes towards medical students.
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The objective of this study was to assess the influence of overcrowding on health care quality provided by emergency departments (ED). The study was carried out in an urban, university tertiary care hospital. All patients seen at the internal medicine unit (IMU) of the ED who returned during the following 72 hours, and those who died in the ED rooms were included in the study. ⋯ We observed a significant, positive correlation between mortality rates and weekly number of visits (p = 0.01). Although a similar trend was also found for revisit rates, such an increase did not reach statistical significance (p = 0.06). It is concluded that since revisit and mortality rates constitute good health care quality markers, present data demonstrate that ED overcrowding implies a decrease in the health care quality provided by it.
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Hypothermia is an important threat in trauma patients. The prevention of accidental hypothermia requires a thermal steady state. ⋯ To simulate possible strategies to prevent hypothermia in the trauma patient the mathematical solution needs to be extended to describe situations where steady state does not exist. From these simulations it can be concluded that infusion heating devices are mandatory in patients with high fluid requirements.
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Randomized Controlled Trial Comparative Study Clinical Trial
The influence of the mode of emergency ambulance transportation on the emergency patient's outcome.
Emergency transport by an ambulance can cause considerable psychical and physical stress for patients. We determined the haemodynamic and endocrinological values of 54 healthy volunteers subjected to one high speed emergency transport and one smooth transport. There were significant differences in all measurements: heart rate (p < or = 0.001), blood pressure, cortisol (p < or = 0.01), prolactin, somatotropine and ACTH between the two modes of transportation. We hypothesize that the additional stress of high speed ambulance transport particularly in patients with acute cardiac disease may result in additional morbidity.
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The aim of this study was to determine and identify the factors associated with shortening or lengthening time interval from stroke onset to performance of computed tomography (CT) scan in stroke patients admitted to three French emergency departments. All suspected stroke patients were eligible (n = 317). The time intervals between stroke onset and presentation to the emergency department and between CT scan request and CT scan performance were determined. ⋯ It is concluded that current delays in stroke management are often incompatible with early treatment. The public needs to be informed and admission procedures reorganized. Improved response to the urgency of ischaemic stroke is required as well as direct access to the scanner during periods of scheduled use.