European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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To determine the reliability of vital signs measured at triage in the emergency department. ⋯ The manual and electronic measurements of vital signs at triage appear to be reliable.
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Body thermoregulation can be violently offset by drugs capable of altering the balance between heat production and dissipation. Such events may rapidly become fatal. The drugs that are involved in the eruption of such syndromes include inhalation anaesthetics, sympathomimetic agents, serotonin antagonists, antipsychotic agents and compounds that exhibit anticholinergic properties. ⋯ Prompt life-saving procedures include aggressive body temperature reduction. Patients with a suspected drug (or non-drug) hypermetabolic reaction should be admitted into an intensive care area for close monitoring and system-oriented supportive treatment. We present six conditions, in decreasing order of gravity and potential lethality, in which hyperthermia plays an essential role, and suggest a clinical approach in such conditions.
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Non-invasive positive pressure ventilation is increasingly used as a first-line treatment for respiratory failure. Non-invasive positive pressure ventilation can reduce the complications of endotracheal intubation such as barotrauma, nosocomial infections and the need for sedation. Non-invasive positive pressure ventilation has been shown to reduce the rate of endotracheal intubation in acute cardiogenic pulmonary oedema (27%), in chronic obstructive pulmonary disease (21%), and in acute respiratory failure (17%). ⋯ In a lung model and in healthy individuals the helmet reduced inspiratory effort. In hypoxemic patients the helmet reduced the intubation rate and the incidence of face mask-related complications. We believe that the helmet can extend the application of non-invasive positive pressure ventilation in different categories of patients with respiratory failure.
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Multicenter Study
National multicentre study of acute intoxication in emergency departments of Spain.
No studies have been published on global acute intoxication in Spanish emergency departments. We therefore designed a multicentre study to identify the epidemiology and management of intoxicated patients in Spain. ⋯ We recorded a slightly lower incidence than other European countries with the same epidemiological profile, except for a low incidence of acetaminophen cases. If we apply the European Association of Poisons Centres and Clinical Toxicologists gastric lavage criteria, there were an important number of unnecessary gut decontamination techniques in drug poisoning. Most patients were treated in emergency departments, without hospital admission.
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The clinical manifestations of pulmonary thromboembolism are non-specific, which makes this condition difficult to diagnose. A case of helical computerized tomography angiographically documented pulmonary thromboembolism, which initially presented as upper abdominal and flank pain, is described. ⋯ The pathogenesis of the pain in the flank and upper abdomen is not known in this case. Unexplained upper abdomen and flank pain in a patient with risk factors for pulmonary thromboembolism, such as rheumatoid arthritis, should be investigated to rule out this treatable but potentially fatal condition.