European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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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
Helicopter Emergency Medical Services save lives: outcome in a cohort of 1073 polytraumatized patients.
In many Western countries, Helicopter Emergency Medical Services (HEMS) have become standard in the prehospital care of severely injured patients. Several studies have shown that HEMS have a positive effect on patient's outcome, although it remains unclear which specific patients benefit most from its care. The aim of this study was to assess the effect of HEMS on the outcome of a large polytraumatized (Injury Severity Score≥16) population. ⋯ On-scene HEMS care has a positive effect on the survival of polytraumatized patients, saving 5.4 additional lives per 100 HEMS deployments. This positive effect is especially observed in patients with abnormal vital signs (respiratory and hemodynamically). Research and revision of dispatch criteria are important to reach patients that benefit most from HEMS care.
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Letter Case Reports
Recreational amitriptyline toxicity mimicking basilar artery stroke.
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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
Malarial cases presenting to a European urban Emergency Department.
Malaria accounts for approximately 225 million infections and 781 000 deaths annually worldwide. Malaria should be considered in the Emergency Department as an important cause of illness in returning travellers. We were interested in evaluating the malarial caseload presenting to an urban inner city Emergency Department in terms of the nature and severity of clinical presentations. ⋯ Malarial cases occurred predominantly in immigrants who were returning to endemic areas to visit friends and relatives in their country of origin. The majority of patients did not undergo antimalarial prophylaxis. Severe malaria is a medical emergency requiring urgent recognition and appropriate antimicrobial and critical care therapy. Improving public awareness and healthcare promotion regarding risks of travel-related malaria may help to improve compliance with prophylaxis and preventative measures, and thereby reduce the prevalence of malarial infection in this group.