European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Review Case Reports
Management of postintubation tracheobronchial rupture: our experience and a review of the literature.
Iatrogenic tracheobronchial ruptures are rare but severe complications after intubation. Therefore, we evaluated the reasons, the therapy and the outcome of patients with postintubation tracheal rupture, who were admitted to our intensive care unit. We reviewed the literature of tracheal rupture after endotracheal intubation in respects of the risk factors, diagnosis, the possible mechanisms of the injury, and suggest strategies of management.
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To measure the dose discrepancy in prescribing simple paediatric analgesia, in the emergency department, by comparing age and actual weight-based dosing. To establish the accuracy of the weight-estimation formula for children [weight kg=2 (age years+4)]. ⋯ Prescribing analgesia by age often results in significant underdosing in the paediatric population. Predicting a child's weight using the calculation may result in underdosing.
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To evaluate the setting of priorities and patients' need for the ambulance service. ⋯ Using the criteria-based dispatch protocol, the personnel at the emergency medical dispatch centres work with a safety margin in their priority assessments for ambulance response. Generally, this 'overtriage' and safety margin for initial priority settings were supported as appropriate by the ambulance staff. According to the judgement of the ambulance staff, one-third of all the patients who were assigned an ambulance response did not require ambulance transport.
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The purpose of this report was to describe the characteristics of patients transported by ambulance, in spite of being evaluated by the ambulance staff at the scene as not requiring prehospital care. A second aim was to compare these patients with those judged as being in need of this care. ⋯ Among the patients transported by the emergency medical service system in the study areas, a significant percentage were judged by the ambulance staff as not being in need of prehospital interventions. The majority were transported by a fully equipped emergency medical ambulance to an emergency medical department at a hospital, without requiring any prehospital interventions either at the scene or during transportation. The emergency medical service organization has to develop clear criteria for the utilization of ambulance services that can be accepted and implemented by the dispatch centres and by healthcare personnel. These criteria need to include safety margins and at the same time enable the appropriate use of resources.
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To evaluate the reasons behind the demographic characteristics of patients presented to emergency departments. ⋯ Demographical trends show that emergency department visits by elderly patients would increase in time. So, in Turkey, emergency department staff should be trained to provide for the special needs of this population in emergency departments.