European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We report a 54-year-old lady who presented to the emergency department for stridor and shortness of breath of acute onset. Nasopharyngoscopy revealed subglottic swelling and plain radiographs revealed a classical 'steeple sign' typical of croup. Although rare, croup should be considered in an adult presenting with stridor to the emergency department and the emergency airway team should be notified in advance for possible surgical airway emergency tracheostomy.
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The FRench Emergency Nurses Classification in Hospital scale (FRENCH) is the first French triage tool for patients visiting an emergency department. The FRENCH scale modified in 2006, based on about 100 determinants (complaints, signs, and vital parameters), allows the triage of adult patients according to five increasing levels of complexity/severity. We evaluated FRENCH version 2 (v.2) in our emergency department. ⋯ FRENCH v.2 is a reliable and validated triage tool to predict the complexity/severity of a patient in our emergency department.
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Cardiac arrest presenting as pulseless electrical activity (PEA) is associated with poor outcome. Its major underlying causes (e.g. cardiac tamponade, pulmonary embolism, tension pneumothorax or hypovolaemia) are difficult to detect reliably in an out-of-hospital setting. We here present a case of a 14-year-old girl suffering from PEA because of cardiac tamponade 4 weeks after surgical closure of a ventricular septal defect. ⋯ Immediate pericardiocentesis was carried out. The girl progressed to complete neurological recovery. This case report demonstrates that focused emergency echocardiography may be useful for the diagnosis of pericardial tamponade leading to cardiac arrest and this diagnosis can be made out-of-hospital by an appropriately trained physician.
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We describe the condition of education and equipment regarding prehospital airway management in the German federal state of Thuringia, representing a part of former Eastern Germany. In 2006 a postal survey of the 39 emergency medical stations (EMS) in Thuringia was carried out. The response rate was 100%. ⋯ Ongoing training and education in airway management is provided in 82% of the emergency districts. This survey reveals wide variations in the equipment for airway management available to prehospital emergency physicians in Thuringia. Given the reported difficulties in airway management, availability of a more standardized set of airway management devices in Thuringia may be helpful.