European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Previous studies have reported that civilian transport is a mortality risk factor in low-resource communities. Few studies have analyzed the chief complaints associated with mortality involving civilian transport after an earthquake.Therefore, the present study was conducted to determine whether mortality resulting from medical professional transport differs from that involving civilian transport, and if so, the chief complaints associated with mortality involving civilian transport after the Wen-chuan earthquake. ⋯ Altered mental status, trunk injury, and shortness of breath were the significant chief complaints associated with mortality involving civilian transport to the hospital after the Wen-chuan earthquake. Our data suggest that patients with any of these complaints should be transported by medical professionals, not civilians, to the nearest hospital for treatment.
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There is an ongoing shortfall of organs for donation in the UK and worldwide. Strategies including donation after circulatory death (DCD), living donation and better identification of potential donors are attempting to increase the number of donors and donated organs. The number of DCD donors in the UK increased by 808% from 37 to 336 between 2001 and 2010 and this is continuing to increase. ⋯ The process of DCD varies between different countries and institutions. The outcome of DCD transplantation has been largely encouraging, particularly for kidneys. The increase in DCD has led to an appraisal of issues that may arise during the donation process; these include the Lazarus phenomenon, the dead donor rule, perimortem interventions, public opinion and conflict of interest for clinicians.
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Randomized Controlled Trial Comparative Study
Emergency airway management by paramedics: comparison between standard endotracheal intubation, laryngeal mask airway, and I-gel.
The aim of this study was to investigate whether briefly trained paramedics would be able to successfully intubate by endotracheal intubation (ETI) and using the laryngeal mask airway (LMA) and the I-gel in a manikin model. After the completion of a questionnaire, a brief educational session, and presentation of ETI, LMA, and I-gel, 72 paramedics were randomly allocated to intubate an adult manikin. ⋯ In addition, the mean insertion time values were significantly affected by the accuracy of the answers to the theoretical questions (P<0.05 for all questions). Paramedics should lay greater emphasis on airway management using supraglottic devices, especially I-gel because of its shorter time of insertion.
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The objective of this study was to describe the type of interconsultations carried out in the Emergency Department (ED) to hospital specialists and analyze their pattern over time. ⋯ The study of interconsultations allows us to identify areas of lesser autonomy of emergency physicians. Changes in the pattern of these interconsultations over time may reflect both learning processes and changes in the healthcare circuits in the ED.
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It is known that visual estimation of blood loss is inaccurate independently from experience and qualification of rescuers or members of hospital staff. There is no information available about the size of a puddle of blood for a given amount of blood depending on the surface. This pilot study evaluated the size of blood puddles on various surfaces. ⋯ The size of puddles of blood depended strongly on the type of surface. Up to 13 times larger blood puddles were found on hard and nonabsorbant surfaces (PVC, concrete) than on absorbant surfaces such as carpet or forest soil.