European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of this study was to identify the risk profile of the victims of violent accidents. During 1997, we studied 1100 patients suffering from injuries produced by violent actions and treated in the emergency department of the largest teaching hospital in the Canary Islands, Spain. Seventy per cent of the patients were male and 30% were female. ⋯ None of the victims died as a result of violence. The admission of victims occurred predominantly during the night hours and 35% of the patients were treated during the weekend. It is concluded that the typical victim of violent accidents in an emergency department of a Spanish teaching hospital is a young male with severe injuries, which occurred during late hours at weekends.
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The 'three in one' block is a well-known locoregional technique for per- and post-operative anaesthesia. This 'three in one' block was investigated in an emergency department with three combinations of local anaesthetics as a locoregional way of pain relief for patients with fractures of the upper femur. A double-blind prospective study was conducted with 61 consecutive patients. ⋯ The technique failed in only four patients due to technical reasons. It was concluded that the 'three in one' block is a fast, safe, reliable and easy technique for pain relief in an emergency department. Good analgesia was achieved for patients with fractures of the upper femur with no need to change the position of the patient.
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The teaching of cardiopulmonary resuscitation (CPR) has had a positive public health impact beyond resuscitating cardiac arrest victims to include recognition of signs and symptoms and prevention of heart attacks. To study the general knowledge and degree of preparedness in the Republic of Poland, a national survey was conducted. ⋯ The results indicate that (1) approximately 75% of the Polish population has received CPR training; (2) the majority of the surveyed population assess their CPR ability as inadequate; (3) the surveyed population believe that CPR training needs to be expanded and improved. Taking into consideration results of the CPR knowledge assessment questions it can be concluded that CPR knowledge in Poland is low and a standardized curriculum for CPR training is needed.
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Comparative Study
Intubation and survival in severe paediatric blunt head injury.
The majority of severe childhood injuries are due to head injuries. We studied the impact of emergency intubation in a cohort of children suffering severe blunt head trauma. A 10-year retrospective case note analysis was performed on 176 children (age < 16 years) with severe blunt head trauma (abbreviated injury scale > or =4) in Southern Finland, who required intensive care in a level 1 trauma centre, or who died despite initiation of life supporting measures at the scene. ⋯ Children intubated at the scene or in the ER of regional hospitals, had significantly worse AIS (head/neck), injury severity score (ISS), and Glasgow coma (GCS) scores than those children intubated in the ER of the level 1 trauma centre. Survival was better in field-intubated children compared with those intubated in regional hospital ERs, despite similar trauma scores (p = 0.05). It is concluded that although children with severe (AIS > or =4) head injury who require emergency intubation have a high overall mortality, field-intubation may improve survival, compared with 'scoop and run' with BLS airway management and deferred emergency intubation.
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Does witnessed cardiopulmonary resuscitation alter perceived stress in accident and emergency staff?
The aim of this study was to ascertain if the presence of patients' relatives during cardiopulmonary resuscitation altered perceived symptoms of stress in accident and emergency personnel participating in resuscitation attempts. An anonymous structured questionnaire survey of all accident and emergency staff participating in non-traumatic adult cardiopulmonary resuscitation was designed to elicit symptoms of an acute stress reaction within 24 hours based on ICD-10 diagnostic criteria. One hundred and fourteen staff replies were received, a reply rate of 89%. ⋯ The grade or role of the staff member had no influence on the presence of stress symptoms. There was no difference in rates of reporting between staff resuscitating in the presence or absence of relatives. It is concluded that the presence of relatives witnessing resuscitation attempts does not affect self-reported stress symptoms in staff participating in resuscitation attempts.