European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study
Prospective performance evaluation of emergency medical services for cardiac arrest in Lombardia: is something moving forward?
Limited data are available in our region on out-of-hospital treatment of cardiac arrest. The aim of this study is to evaluate whether the changes implemented in the emergency system (i.e. an increased number of basic life support and advance life support crews that were dispatched) produced the expected outcome improvements. ⋯ The strengthening of only one link of the chain-of-survival did not improve 1 month survival.
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Multicenter Study
The impact of a temporary ice-rink on an emergency department service.
A temporary ice-rink opened close to Cork city for 6 weeks from 30 November 2003. During this time, a number of patients presented to the local emergency departments with ice-skating-related injuries. We documented these injuries. ⋯ A temporary ice-rink had a significant impact on local emergency departments. Currently, there is no specific legislation in Ireland relating to public health and safety in ice-rinks. We recommend consultation with local public bodies before opening such facilities, and appropriate regulation.
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Comparative Study
Initial symptoms in pulmonary embolism differ from those in pneumonia: a retrospective study during seven years.
To compare initial symptoms in pulmonary embolism with community-acquired pneumonia and relate to C-reactive protein and pulmonary infiltrates in order to improve the clinical assessment at the emergency department. ⋯ Pulmonary infiltrates, high fever and a high level of C-reactive protein can deceive the physician to suspect pneumonia instead of pulmonary embolism. Classical initial symptoms ought to direct the physician in diagnosing pulmonary embolism. We emphasize a detailed patient history of initial symptoms.
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To evaluate the quality of care in patients with pain who visit the emergency department of a university hospital and the evolution of their pain during their emergency department stay. ⋯ Even if pain has been identified, its assessment and management remains inadequate. The quality of care may be improved by educating the personnel in developing protocols and in evaluating pain management.
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Gunshot injuries to the chest often require urgent admission to the nearest hospital, because of the cardiorespiratory status, transfer to a hospital without a cardiothoracic unit might be unsafe. In this case, a male patient was transferred to the nearest hospital on being shot through the heart. ⋯ We report our treatment regime for thoracic injuries and the specific management of this patient. We conclude that every hospital with an accident and emergency department has to be prepared for such an injury and that operative management is possible without cardiopulmonary bypass.