European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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To develop and validate a prediction model for the early identification of children with pneumonia in emergency care settings. ⋯ The risk of pneumonia can be assessed using three key clinical characteristics - overall assessment of the severity of illness, breathing rate, and oxygen saturation. Serum C-reactive protein contributes to the prediction of an intermediate risk of pneumonia in children. Children with a low risk of developing pneumonia with vital signs in the normal range can be discharged with effective safety netting, requiring neither antibiotics nor radiographs.
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To identify the prevalence, predictors and outcomes of patients who leave without being seen (LWBS) in one hospital emergency department (ED). ⋯ Outcomes investigated in this study indicate that room for improvement exists not only for patients who LWBS but all patients presenting to the ED. The most powerful predictors of LWBS were lower urgency triage allocation and evening and night shift presentations. This suggests that service improvements could be targeted during 'out of business hours' for those with less emergent conditions.
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The debate on whether midshaft clavicular fractures should preferably be treated operatively or nonoperatively still continues. Several patient-related factors may influence this treatment decision. A retrospective study was carried out to determine the relation between fracture type and trauma mechanism, age and sex, and the influence of these factors on the choice of primary treatment. ⋯ Age has a major influence on the fracture type, whereas the trauma mechanism does not. The choice for the surgical treatment of midshaft clavicular fractures is primarily determined by the amount of axial shortening of the clavicle, rather than by the overall displacement or fracture type. Over the years, the choice of treatment seems to have been increasingly influenced by the patient's and surgeon's preferences.
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User surveys show that there have been significant changes over the last decade in the recreational drugs that are available and being used. This study aims to determine whether there have been similar trends in the drug(s) used by individuals presenting to the emergency department (ED) with acute recreational drug toxicity. ⋯ Data collection on the drug(s) used in individuals presenting to specialist clinical toxicology centres and/or sentinel EDs across Europe with acute recreational drug toxicity would help to determine the true pattern(s) of drug use and the acute harm associated with this use across Europe and trends over time.