European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Febrile infants undergoing urethral catheterization (UC) are often not treated for pain and distress. The aim was to evaluate the effectiveness of midazolam premedication. We compared a convenience sample of infants who underwent UC with midazolam with those who did not receive midazolam. ⋯ Serious adverse events were not observed during sedation and at 48 h after discharge. Study participants had longer emergency department length of stay compared with the controls (191.5 vs. 139 min, P<0.017). In this cohort, midazolam significantly reduced the distress associated with UC without causing serious adverse events.
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Zipper injuries are highly distressing to patients and often difficult to manage. Several management techniques are described in the literature. ⋯ This novel technique is quick, nontraumatic and requires readily available equipment. It has been used successfully in two patients who were ineligible for a circumcision.
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As one of Europe's most densely populated countries with multiple nuclear installations and a prominent petrochemical industry, Belgium is at some reasonable risk for terrorist attacks or accidental chemical, biological, radiation, and nuclear (CBRN) incidents. We hypothesize that local hospitals are not sufficiently prepared to deal with these incidents. ⋯ There are serious gaps in hospital preparedness for CBRN incidents in Belgium. Lack of financial resources is a major obstacle in achieving sufficient preparedness.
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Critical care paramedics (CCPs) have been introduced by individual ambulance trusts in England, but there is a lack of national coordination of training and practice. We conducted an online survey of NHS ambulance services to provide an overview of the current utilization and role of CCPs in England. The survey found significant variations in training, competencies and the working patterns of the ∼90 CCPs working in five ambulance services. ⋯ The CCP model established in five ambulance services in England is unique within Europe. With increasing numbers of CCPs, concerns about lack of supportive scientific evidence and clinical need should be addressed. Optimal delivery of prehospital critical care in England remains controversial.
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Care providers need accurate information to help them effectively manage patient flow in emergency departments (EDs) and deliver high-quality care within time constraints. Data should alert care providers to clinical risk and poor patient experience. In England, NHS A&E guidance proposes, among others, three measures to understand the distribution of waiting times in EDs - the median wait, 95th percentile and maximum wait. This study explores how well these three measures monitor performance and the potential added value of scatterplots. ⋯ The use of scatterplots could help care providers better understand the distribution of waiting times in EDs, identify where EDs struggle to deliver care against time constraints and highlight poor patient experience and prompt action to address concerns.