European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The objective of this study was to identify factors that influence emergency nurses' adherence to an emergency department national protocol (EDNP). A survey of emergency nurses (n=200) and physicians with medical end responsibility on an emergency department (n=103) was carried out. Emergency nurses' self-reported adherence to the EDNP was 38%, 55% of the nurses and 44% of the physicians were aware of the protocol. ⋯ The main influencing factor seems awareness. Other factors related to the individual, the organization and to protocol characteristics. Solely disseminating the EDNP is not enough to get the protocol used in clinical practice.
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To determine the effects of a communication skills training program on emergency medicine residents and patient satisfaction. ⋯ Participation in a communication skills training program was associated with improved communication skills of emergency medicine residents, increased patient satisfaction, and decreased complaints.
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Randomized Controlled Trial
A comparison of the i-gel and classic LMA insertion in manikins by experienced and novice physicians.
Airway management is of utmost importance in critical patients, for whom endotracheal intubation remains the gold standard. However, it is a difficult skill to acquire and success rates in novices are unacceptably low. Supraglottic devices constitute promising alternatives. The aim of this study was to assess the use of laryngeal mask airway (LMA) classic LMA (cLMA) and a relatively new supraglottic device, the i-gel, in experienced and novice doctors in a manikin setting. ⋯ In this manikin setting i-gel significantly improved success rates and insertion time compared with cLMA. Most importantly, i-gel use resulted in high first pass success rates for novice doctors, equal to those achieved by experienced doctors.
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In this study, we aimed to compare serum creatinine, blood urea, and glomerular filtration rate (GFR) levels of patients at baseline and 48 h after the administration of radiocontrast agent in the emergency department. ⋯ There was no statistically significant difference between basal and 48 h after the administration of radiocontrast agent serum creatinine and GFR levels of patients who were enrolled in this study. Results had shown that administration of intravenous radiocontrast agent (≤100 ml) for emergency imaging in the emergency department did not produce a risk for contrast-induced nephropathy in patients with serum creatinine levels of 1.5 mg/dl or less.
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The objective of this study was to evaluate the supplemental oxygen use in hospital emergency departments (EDs) in Victoria. A prospective exploratory design was used. All patients attending the three-study EDs during the data-collection periods and who could give informed consent were eligible for inclusion. ⋯ Patients who received oxygen were older (P<0.001), had higher incidence of ambulance transport to ED (P<0.001) and hospital admission (P<0.001) and higher median respiratory (P<0.001) and median heart rates (P=0.008). Oxygen is a major component of emergency care. Patients who received oxygen were more likely to have clear evidence of physiological abnormalities; however, oxygen decision-making warrants more detailed investigation.