European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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This topic highlights the results of the literature review on calcium therapy during cardiac arrest and cardiopulmonary resuscitation according to the Patient/population, Intervention, Comparator, Outcome structure. Eligible studies were assigned to one of the five levels of evidence. Their quality was rated as either good, fair, or poor and then classified as supportive, neutral, or opposing according to the outcome benefits. ⋯ There is no evidence that the administration of calcium during cardiopulmonary resuscitation improves survival from cardiac arrest irrespective of the presenting rhythm. In the setting of hyperkalemia, calcium channel blocker intoxication, hypocalcemia, and hypermagnesemia, the role of calcium remains unclear because of the limited amount of evidence. The main limitation is the scarcity of data, most of which relate to anoxic cardiac arrest, accounting for no more than 25% of the causes of cardiac arrest in humans.
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Comparative Study
Chief complaints in medical emergencies: do they relate to underlying disease and outcome? The Charité Emergency Medicine Study (CHARITEM).
To evaluate the relationship between chief complaints and their underlying diseases and outcome in medical emergency departments (EDs). ⋯ The majority of emergency patients lack diagnosis-specific symptoms. Chief complaints help preselect patients but must not be mistaken as disease specific. Mortality largely differs depending on the chief complaint. In chest pain patients, standardized processes may be one factor that explains the low mortality in this group.
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Paediatric emergency medicine (PEM) currently faces many competing educational challenges. Recent changes to the working patterns have made the delivery of effective teaching to trainees extremely difficult. We developed a virtual learning environment, on the basis of socioconstructivist principles, which allows learning to take place regardless of time or location. The aim was to evaluate the effectiveness of a blended e-learning approach for PEM training. ⋯ A blended approach to e-learning in basic PEM is effective and enjoyable to trainees.
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Review Comparative Study
Development of key performance indicators for emergency departments in Ireland using an electronic modified-Delphi consensus approach.
The objective of this study was to develop a consensus among emergency medicine (EM) specialists working in Ireland for emergency department (ED) key performance indicators (KPIs). ⋯ Employing a Delphi consensus process, it was possible to reach a consensus among EM specialists in Ireland on a suite of 97 KPIs for EDs.
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Comparative Study
Electroencephalographic findings in consecutive emergency department patients with altered mental status: a preliminary report.
Electroencephalography (EEG) can help narrow the differential diagnosis of altered mental status (AMS) and is necessary to diagnose nonconvulsive seizure (NCS). The objective of this prospective observational study is to identify the prevalence of EEG abnormalities in emergency department patients with AMS. Patients of at least 13 years of age with AMS were enrolled, whereas those with an easily identifiable cause (e.g. hypoglycemia) underlying their AMS were excluded. ⋯ NCS was diagnosed in three (6%, 1-17%), including one patient in nonconvulsive status epilepticus. Nine patients (18%, 10-31%) had interictal epileptiform abnormalities, indicating an increased risk of spontaneous seizure. Patients presenting to the emergency department with AMS have a high prevalence of EEG abnormalities, including NCS.