European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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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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We aimed to assess the suitability of right ventricular outflow tract (RVOT) fractional shortening for estimating low central venous pressure (CVP). To the best of our knowledge, there have been no similar studies in the English language literature. ⋯ In the hands of emergency physicians, a RVOT fractional shortening measurement is a good predictor of low CVP.
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Despite an increase in research, there is still a lack of knowledge about patient safety in emergency departments (EDs) in many European countries. The aim of this study was therefore to describe the incidence and types of reported medical errors and complaints in ED care in Sweden. ⋯ Medical errors and complaints at Swedish EDs, as reported by both patients and care providers, were related mainly to diagnostic procedures and treatments.
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The intra-aortic balloon pump (IABP) was first introduced in 1968 to augment cardiac output in the haemodynamically unstable patient and serve as a bridge to treatment options such as coronary artery bypass grafting and cardiac transplantation. Transfer of IABP-dependent patients for upgrade of clinical care is increasingly common and safe. In Australia, percutaneous coronary intervention centres can be located outside cardiothoracic surgical centres. This study reviews IABP medical retrieval by a doctor/paramedic team after implementation of a standardized protocol. ⋯ Our system offers a safe method of IABP medical retrieval. The doctor and paramedic combination complements strengths in logistics and critical care. This serves as a guide to other systems looking to put in place a similar model of 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.