European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study Observational Study
Diagnosing pulmonary edema: lung ultrasound versus chest radiography.
Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. ⋯ Residents were able to more accurately identify pulmonary edema with lung ultrasound than with chest radiograph. Physicians with minimal exposure to lung ultrasound may be able to correctly recognize pulmonary edema on lung ultrasound.
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Clinical Trial
Acquiring basic life support skills in a self-learning station: video alone is not enough.
To develop a self-learning station combining a video with computer exercises to learn cardiopulmonary resuscitation (CPR) to novices, and to assess the efficacy of these two components on CPR acquisition. ⋯ Although in a self-learning station video training can introduce CPR skills to novices, additional voice-feedback exercises were needed to achieve acceptable CPR quality.
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In the UK, many emergency departments (EDs) were built with dedicated theatres reflecting surgical origins. This study assessed the number and type of procedures performed in such a facility over a 16-year period. A retrospective cohort study of ED theatre usage was carried out in Aberdeen Royal Infirmary from 1995 to 2010. ⋯ Use of ED theatre has reduced considerably. The reasons for this are complex, but may reflect a reduction in the surgical skill set of staff in the ED. Sound basic surgical skills are valuable to the emergency physician and further consideration should be given to how these are best acquired in the course of training.
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Randomized Controlled Trial
Evaluation of advanced airway management in absolutely inexperienced hands: a randomized manikin trial.
Endotracheal intubation (ETI) and basic ventilation techniques (i.e. mouth-to-mouth/nose, bag-valve-mask ventilation) require skills and training. As an alternative, supraglottic airway devices (SAD) are efficient and technically easy to insert. We therefore evaluated the time to ventilation, success rate, and skill retention for various airway management approaches by medical laypersons using a manikin model. ⋯ A variety of SAD all proved to reliably secure airways quickly, even in the hands of complete novices. The SAD were much more effective than ETI, which often failed, and were even superior to mouth-to-mouth ventilation. SAD may thus be an appropriate first-line approach to field ventilation.
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Observational Study
Feasibility of introduction and implementation of the Surviving Sepsis Campaign bundle in a Singapore Emergency Department.
The Surviving Sepsis Campaign has been shown to improve the outcome of patients with severe sepsis or septic shock in Europe and North America. We aim to examine the impact of implementing the severe sepsis resuscitation bundle as part of standard care at the National University Hospital Emergency Department (ED) and assess its feasibility in Singapore. ⋯ There was zero compliance to the severe sepsis resuscitation bundle at baseline. Quality improvement initiatives resulted in better compliance and outcome for patients, showing that such a protocol of management is feasible in a typical Singapore ED.