European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Observational Study
Blood culture diagnostic yield in a paediatric emergency department.
Blood culture (BC) is one of the most commonly used microbiological tests in the paediatric emergency department (PED) despite its lack of immediate diagnostic utility. Our objectives were to uncover the reasons for BC in the PED, to review adherence to the current protocol for this technique, and to analyse the diagnostic yield (DY) of BC in localized bacterial infections. ⋯ FWS is the main reason for BC in the PED. One-quarter of the BCs were not indicated, with the DY null in these cases. Due to the low DY in certain localized bacterial infections, a strict individualized ordering of BC in these cases should be considered.
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The aim of this study was to assess the walkout rate and to identify influencing patient and visit characteristics on walkout. Furthermore, we assessed the reasons for leaving and medical care needs after leaving. ⋯ The average observed daily walkout rate was 1.4 patients over the 4-month period. In general, walkouts are self-referrals with lower urgent complaints, arriving during the evening or night shift or during crowded conditions. Most walkouts leave because of perceived long waiting times.
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The prevalence of obesity is rising worldwide. To investigate how fixed-wing air ambulances handle bariatric transfers, we conducted a survey addressing logistical and medical issues. A questionnaire was sent to 24 air ambulance companies in Europe. ⋯ Dedicated tools for transferring, bedding, and securing patients are available very inconsistently. Medical provisions such as airway management, monitoring, and vascular access for the obese reach high standards. While medical resources for obesity-related problems reach a high standard, poor logistical preparations could lead to harm for patient and medical escort alike.
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After shoulder trauma, most fractures and dislocations are easily recognized on radiographic examination; however, the opposite is true for rotator cuff injuries. As a consequence, shoulder complaints may persist or arise due to unrecognized cuff injury. The objective of this study was to investigate the prevalence of shoulder pain and symptomatic rotator cuff ruptures 1 year after shoulder trauma without fracture or dislocation. ⋯ Emergency physicians should be aware that normal radiography does not exclude the presence of a rotator cuff tear in patients with a history of shoulder trauma. Regular follow-up is essential for discovering rotator cuff injuries. In this study, 32% still suffered from shoulder pain 1 year after shoulder trauma, and re-examination revealed a prevalence of 9% symptomatic rotator cuff ruptures.