European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
Tracheal intubation during chest compressions performed by qualified emergency physicians unfamiliar with the Pentax-Airwayscope.
Experienced emergency physicians were recruited and a randomized crossover trial was conducted to compare the performance of the Pentax-Airwayscope (AWS) video-laryngoscope with the Macintosh laryngoscope (McL) for tracheal intubation during continuous chest compressions under three different scenarios: (1) normal airway, (2) limited neck mobility, and (3) tongue edema. ⋯ Although participants were experienced emergency physicians familiar with the McL and unfamiliar with the AWS, the AWS proved to be a better tool than the McL to perform tracheal intubation during continuous chest compressions on a manikin. The AWS should be considered as an initial intubating tool to perform tracheal intubation during continuous chest compressions rather than the McL.
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The aim of this study was to analyze the impact of diverting off-hour calls to Emergency Medical Dispatch Centers (EMDC) on time delays and revascularization procedures for patients with ST-segment elevation myocardial infarction (STEMI) in a French region. ⋯ In a real world setting, improving the quality of prehospital organization was effective not only on reducing delays but also on improving access to revascularization. Our results showed the beneficial impact of EMDC implementing on management of STEMI.
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Multicenter Study
Accuracy of emergency physician-performed ultrasound in detecting traumatic pneumothorax after a 2-h training course.
Pneumothorax is one of the leading causes of preventable death in trauma patients. Chest radiograph has a lower sensitivity than a computed tomography (CT) scan for the diagnosis of pneumothorax. ⋯ After just a 2-h training course, emergency physicians showed a good success rate in finding pneumothoraces. Thoracic US can be an easy to learn and an accurate diagnostic modality for the detection of traumatic pneumothorax in emergency departments.
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The aim of the study was to provide an overview on the current evidence on the method of cardioversion in patients presenting with recent-onset atrial fibrillation at the emergency department. ISI Web of Science and MEDLINE were explored for articles published between January 2000 and December 2011 in English or Spanish for the keywords 'acute', 'recent-onset' or 'paroxysmal' AND 'atrial fibrillation' AND 'treatment' AND 'emergency'. Original published articles were included if they enrolled patients with atrial fibrillation episodes of short duration (<48 h) and if they specifically addressed time to conversion, length of stay in the emergency department, safety, and/or relapses. ⋯ Amiodarone had a longer conversion time, with a similar rate of acute adverse events. Cardioversion in the emergency department is feasible and safe. Direct current cardioversion is the most effective therapeutic strategy.
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Tertiary trauma survey is widely implemented in trauma care to identify all injuries in trauma patients. However, various studies consistently show that some trauma patients have missed injuries. In this study, we developed a clinical decision model to identify patients who are at risk for delayed diagnosed injuries. ⋯ Our newly developed clinical decision model can identify patients who are at a risk for delayed diagnosed injuries and who should undergo an intensified search for potential unidentified injuries.