European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The Emergency Medical Services (EMS) play a primordial role in the early management of adults with acute ischaemic stroke (AIS). The aim of this study was to evaluate the role and effectiveness of the EMS in the stroke chain of survival in Marseille. ⋯ Our study demonstrates that public intervention programmes must stress the urgency of recognizing stroke symptoms and the importance of calling EMS through free telephone numbers. Further efforts are necessary to disseminate guidelines for healthcare providers concerning stroke recognition and the new therapeutic possibilities in order to increase the likelihood of acute stroke patients presenting to a stroke team early enough to be eligible for acute treatment. In addition, EMS dispatchers should receive further training about atypical stroke symptoms, and 'Face Arm Speech Test' tests must be included in the routine questionnaires used in emergency medical calls concerning elderly persons.
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We aimed to evaluate the predictive value of pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure, respiratory rate (RR), oxygen saturation (SaO2), and the Glasgow Coma Scale (GCS) for cardiac arrest and death in critically ill patients. ⋯ Not all vital signs are useful in the prediction of clinical outcomes. Vital signs had high specificity but very low sensitivity as predictors of clinical outcomes. Clinicians should always remember to treat patients and not numbers.
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Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. ⋯ The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims.
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To investigate whether patients came directly to the emergency department (ED) or whether they had taken any other actions or activities within the healthcare system before attending the ED. An additional aim was to increase our understanding of the potential determinants between patients' ED-seeking behaviour and patient-related data. ⋯ A large proportion of ED patients sought previous healthcare before seeking care at the ED. Female patients and patients with longer symptom duration more often sought other caregivers before seeking ED care.
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We conducted a retrospective study of 291 patients aged 75 years or older who were admitted to the emergency department and who underwent a computed tomography (CT) brain scan. Our aims were to assess the reasons for requesting an urgent CT brain scan, to record the diagnostic yield of cerebral imaging, and to seek out predictive factors of an intracranial pathology. ⋯ In our elderly population, we found no typical patient profile when concerned with the risk of having an intracranial pathology. The multivariate logistic regression found that predictive factors for intracranial bleeding were localizing signs, disorders of consciousness with a Glasgow Coma Score of less than 14, head trauma, sudden-onset headache, or headache associated with at least two episodes of vomiting.