European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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To design an effective, efficient, and affordable radiation surveillance system to screen every emergency department (ED) visitor before they enter the ED. ⋯ Radiation threat to the ED, although uncommon, is real. For the safety of everyone in the ED, you can install an effective, efficient, but affordable surveillance system similar to ours if your ED is not exempted from this threat.
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To examine the feasibility and diagnostic value of a novel prehospital chest ultrasound algorithm in patients with dyspnea. ⋯ Prehospital chest emergency sonography trial is a novel prehospital ultrasound algorithm for patients with dyspnea. Pleural effusion may serve as a novel prehospital marker for patients with decompensated CHF, thus facilitating the often difficult differential diagnosis between CHF and COPD.
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Comparative Study
Epidemiology of assault and self-harm injuries treated in a large Romanian Emergency Department.
Intentional injury, including interpersonal violence and self-harm, is one of the world's leading causes of preventable injury. In Europe alone, nearly 1.5 million individuals receive medical treatment each year for a violence-related injury. We examined violent injuries treated in the largest Emergency Department (ED) in Tîrgu Mures County, Romania, with a catchment area of approximately 580 000 residents to describe the epidemiology of assault and self-harm injuries. ⋯ Of all injuries treated in the Tîrgu Mures ED, one out of five was violence related. One out of 10 patients that suffered an injury as a consequence of a violent event and treated in the ED required admission to a hospital for further medical care, leading to a significant health care burden. These data suggest that prevention strategies should focus on young adults, and particularly men. Interventions that focus on detection and treatment of psychological illness, reduction of alcohol use and associated aggression, and family and intimate partner violence are suggested as priorities.
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Increasing evidence supports a role for contrast-enhanced ultrasound in the assessment of blunt abdominal trauma. Accurate definition of organ injury can be demonstrated, as well as extension to solid organ capsule and even vascular injury. Low-dose contrast is needed for renal imaging, to avoid obscuration of deeper structures from intense cortical enhancement. ⋯ The spleen is best assessed in the delayed phase, thereby limiting misinterpretation of early heterogeneous contrast uptake. Typical sonographic features of traumatic injuries of the solid abdominal organs are described. Although contrast-enhanced computed tomography is the gold standard modality for imaging abdominal organ traumatic injury, contrast-enhanced ultrasound has developed a role in the emergency setting, particularly in low-energy injuries and in follow-up of traumatic injuries.
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Comparative Study
The First View Concept: introduction of industrial flow techniques into emergency medicine organization.
The number of patients seeking treatment in emergency departments is rising, although many governments are seeking to reduce expenditure on health. Emergency departments must achieve more with the same resources or perform the same functions with fewer resources. Patients demand higher emergency clinical care quality, with low waiting times viewed as a key quality criterion by many patients. ⋯ After introduction, 3269 patients had a median waiting time before first specialty physician contact of 11.2 min, a first quartile waiting time of 9.1 min, and a third quartile waiting time of 15.2 min. Industrial flow concepts can achieve significant improvements in emergency department workflows in countries in which sufficient numbers of specialty physicians are available. More attention to the organization of emergency department working processes is needed, especially involving lean management.