European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The interobserver variability of capillary refill time (CRT) has been questioned. Earlier studies of interobserver variability of CRT have been on a large number of patients but with few observers. The objective of our study was to investigate how a large group of nurses and nurse assistants would grade CRT. ⋯ This is the largest interobserver study of CRT when looking at the number of observers. We found an only moderate agreement for the exact value of CRT and a moderate agreement for normality. We believe that CRT should be used with caution in clinical practice.
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The diagnosis of patients with acute dyspnoea is challenging, as clinical history and physical examination are often nondiagnostic and inaccurate. Consequently, clinicians often rely on the results of chest radiography (CXR) to determine the initial intervention and guide further treatment. ⋯ US-JVD is a sensitive test for identifying pulmonary oedema on CXR in dyspnoeic patients with suspected congestive heart failure.
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The use of Celox, a chitosan-based haemostatic agent, for the control of massive traumatic bleeding in patients arriving at a ROLE 2 (Enhanced Care) Facility in southwestern Afghanistan is described. Twenty-one soldiers with gunshot wounds were treated with successful haemostasis in 18 at the first application and in three after further applications. Celox is an effective haemostatic agent and a useful adjunct for the treatment of massive traumatic bleeding.
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The objective of this paper was to assess the resuscitation training and knowledge status of medical and surgical residents (SRs). A questionnaire of 23 questions was answered by medical and SRs in an Athens General Hospital. The questionnaire was designed based on the 2005 resuscitation guidelines. ⋯ With regard to the knowledge questions, the mean score, on a maximum scale of 10, was 5.39±1.93 for the medical residents and 5.27±2.33 for the SRs. Their resuscitation knowledge was positively influenced by their attendance of Basic Life Support (P=0.005) and Advanced Life Support/Advanced Cardiac Life Support courses (P=0.013). Residents in this tertiary general hospital in Athens had inadequate knowledge of resuscitation guidelines and the majority of them were not currently certified in any of these courses.
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Comparative Study
How different are older people discharged from emergency departments compared with those admitted to hospital?
To compare the characteristics of older people presenting to the emergency department (ED) and admitted to hospital with those discharged directly from the ED and identify factors independently associated with hospital admission. ⋯ In this elderly population, health-related variables were the only independent factors associated with hospital admission. Approximately 30% of patients discharged home from ED had similar risk profiles to admitted patients.