European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Case Reports
Severe metformin intoxication treated with prolonged haemodialyses and plasma exchange.
Biguanides pose a significant risk of morbidity, mortality and permanent sequelae secondary to prolonged periods of hypoglycaemia. ⋯ For the maximum elimination of metformin, extended haemodialysis is required and the treatment of the accompanying metabolic acidosis with bicarbonate is important for the effectiveness of the treatment. Patients benefit much more from the treatment of combined haemodialysis with plasma exchange.
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Comparative Study
Comparison of the Full Outline of Unresponsiveness Score Coma Scale and the Glasgow Coma Scale in an emergency setting population.
The Glasgow Coma Scale (GCS) is the most widely used tool for the evaluation of the level of consciousness. The Full Outline of Unresponsiveness (FOUR) Score is a new coma Scale that was developed considering the limitations of the GCS, and has been found to be useful in an intensive care setting. We aimed to compare FOUR Score and GCS in the emergency setting. ⋯ The new coma Scale, FOUR Score, is not superior to the GCS. However, the combination of the eye and motor components of FOUR Score is a valuable tool that can be used instead of either the FOUR Score or GCS.
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Documenting the quality of emergency dispatch centres handling of emergency calls regarding intoxicated unconscious patients. ⋯ On the basis of the interviews and the survey, cases were handled according to guidelines. The log recordings, however, disclosed deviation from the protocol. Alcohol intoxication was associated with higher rate of deviation from the protocol compared with other intoxications.
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Comparative Study
Performance of the Wells and Revised Geneva scores for predicting pulmonary embolism.
The objective of the study was to compare two scoring methods to predict the risk of pulmonary embolism (PE) as diagnosed with computed tomography angiography (CTA) and/or CT venography (CTV). ⋯ The Wells rule seems to be more accurate among both inpatients and emergency department patients. The Revised Geneva score can be used in emergency department patients with high reliability.
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Emergency residency training programs, which have been developing in Turkey over the last 14 years, have been improving emergency health services by training each year a significant number of emergency medicine specialists. Sufficient data about these emergency residency training programs is not currently available. The purpose of this study is to determine (i) the structure of emergency residency training programs and (ii) trainer and resident views concerning these programs. ⋯ Most of the departments have developed the basic components for resident education. Residents and trainers frequently had different views on their own level of knowledge, practical skills, and the content of their training.