European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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This study aimed to test the hypothesis that there is a difference in mortality between patients hospitalized with acute chest pain in a university hospital and those hospitalized in a county hospital, and to describe differences in characteristics and use of medical resources in these two settings. All patients hospitalized at Sahlgrenska University Hospital in Göteborg (with a catchment population of 706 inhabitants/km(2)) and Uddevalla County Hospital (with a catchment population of 34 inhabitants/km(2)) with symptoms of acute chest pain during a registration period of 6 months were included in the study. A total of 1592 patients in the city hospital and 822 in the county hospital fulfilled the given criteria for inclusion. ⋯ When correcting for differences at baseline, the risk ratio for death in the county hospital versus the city hospital was 0.84 (95% confidence interval 0.51-1.40, P=0.53). In conclusion, among patients hospitalized with acute chest pain in a city university and a county hospital the mortality during the subsequent 30 days did not differ. However, there were differences in terms of the use of medical resources and in previous history, chronic medication prior to hospital admission and status on admission between the two cohorts.
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Review Case Reports
Pulmonary oedema in SCUBA divers: pathophysiology and computed risk analysis.
SCUBA diving has become a popular sport, with an increasing number of people participating in it. Although it is an essentially very safe activity, several specific medical problems are associated with diving. The present paper addresses diving-related pulmonary oedema, which is a rarely reported condition. ⋯ Consequently, we could design and construct a bio-mechanical computer model of the alveolar septa to explore the pathophysiology of diving-related pulmonary oedema and the vulnerability of individual divers as they relate to some mechanical characteristics of their lung structure. The physiological mechanisms of diving-related pulmonary oedema and the results provided by the computational model successfully delineated the process. The model predicted that the risk of injury is significantly increased in individuals who have a stiffer lung parenchyma or lower lung compliance values.
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Airway management is the cornerstone of resuscitation. Emergency endotracheal intubation is more likely to be difficult in the accident and emergency (A&E) department setting compared with the operating room. A&E departments must have an appropriate selection of equipment to deal with difficult airway problems. ⋯ It is concluded that airway equipment in Scottish A&E departments is adequate for basic airway care and endotracheal intubation. Nearly all departments have access to a suitable rescue device for the failed or difficult airway. Capnographic confirmation of tube placement should be mandatory in A&E.