European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Review Biography Historical Article
Emergencies and acute diseases in the collected works οf Hippocrates: observation, examination, prognosis, therapy.
The collected works οf Hippocrates include a wealth of references to emergencies and acute conditions; if the physician could treat these, he would be considered superior to his colleagues. Works most relevant to current Emergency Medicine are presented. ⋯ They assigned great significance to distressing signs and symptoms - the famous Hippocratic face, the breathing pattern, pain, seizures, opisthotonus - pointing to a fatal outcome, which they reported to their patient. The principles of treatment of emergencies, such as angina, haemorrhage, empyema, ileus, shoulder dislocations and head injuries, are astonishingly similar to the ones used nowadays.
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To evaluate whether prioritization of patients with acute heart failure (AHF) in the Andorran Triage Model/Spanish Triage System (MAT/SET) and the Manchester Triage System (MTS) also allows the identification of different profiles of outcome and prognosis and determine whether either system has a better predictive capacity of outcomes. ⋯ The prediction of the outcome of patients with AHF determined with the MAT/SET or MTS showed scarce differences between the two systems, and their discriminative capacity does not seem to be clinically relevant.
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Randomized Controlled Trial Comparative Study
Interactive videoconferencing versus audio telephone calls for dispatcher-assisted cardiopulmonary resuscitation using the ALERT algorithm: a randomized trial.
The ALERT algorithm, a telephone cardiopulmonary resuscitation (CPR) protocol, has been shown to help bystanders initiate CPR. Mobile phone communications may play a role in emergency calls and improve dispatchers' understanding of the rescuer's situation. However, there is currently no validated protocol for videoconference-assisted CPR (v-CPR). We initiated this study to validate an original protocol of v-CPR and to evaluate the potential benefit in comparison with classical telephone-CPR (t-CPR). ⋯ The v-CPR protocol allows bystanders to reach compression rates and depths close to guidelines and to reduce 'hands-off' events during CPR.
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There is often little consensus on the levels of trainees' performances, given the varied expertise and experience of the assessors, different tasks to be assessed and dynamic circumstances. Consequently, assessors are considered to be a major source of measurement error in workplace assessment. The aim of this pilot study is to assess the inter-rater reliability and agreement of a hybrid framework for assessment of nonspecialist doctors in our Emergency Department. ⋯ The use of our hybrid framework improved the inter-rater reliability and agreement in our Emergency Department for a specific group of learners who have had previous Emergency Medicine experience. To improve the reliability of ratings, faculty development has to address how observations and assessments should be synthesized into an overall rating.
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Observational Study
Management of body stuffers presenting to the emergency department.
The aim of this study was to establish a management protocol for body stuffers presenting to the emergency department. ⋯ Patients developed new or worsening features of drug toxicity within 6 h of presentation. Toxidromes observed are often not drug/class specific, and treatment including gut decontamination and radiography do not aid in expediting discharge. We propose an observation period of 6 h from the time of admission as the time required if the patient is asymptomatic or there is resolution of presenting signs and symptoms.