European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study
Agreement between ambulance and hospital records for information promoting urgent stroke treatment decisions.
Rapid decision-making during acute stroke care can improve outcomes. We wished to assess whether crucial information to facilitate decisions is routinely collected by emergency practitioners before hospital admission. ⋯ In a retrospective cohort of stroke patients admitted by emergency ambulance, standard practice did not consistently result in prehospital documentation of information that could promote rapid treatment decisions. Training emergency practitioners and/or providing clinical protocols could facilitate early stroke treatment decisions, but prehospital information availability is likely to be a limiting factor.
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Blood cultures are performed in the emergency room when sepsis is suspected, and a cohort of patients is thereby identified. The present study investigated the outcomes (mortality and length of hospital stay) in this group following an emergency medical admission. ⋯ A clinical decision to request a blood culture identified a subset of emergency admissions with markedly worse outcomes. This patient cohort warrants close monitoring in the emergency setting.
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Randomized Controlled Trial Multicenter Study Comparative Study
Weaker compressions after night shift? The WeCAN manikin study.
To assess whether the quality of chest compressions (CC) differs before and after a night shift. We carried out a cluster randomized study in three Emergency Departments and three ICUs in Paris, France. Physicians were assessed on a control day and immediately following after a night shift. ⋯ The proportion of CC with a depth greater than 50 mm was similar on a control day and after a night shift [52% in both groups, mean difference of 0 (95% confidence interval: -17 to 17)]. Other indicators of CC quality were unchanged after a night shift, except for the mean depth of CC (51 vs. 48 mm, P=0.01). We report in our sample that the quality of CC after a night shift is not inferior to a control day.
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The European Paediatric Life Support (EPLS) provider course aims at training doctors and nurses in the efficient and prompt management of cardiopulmonary arrest in children. EPLS is a 2-day European Resuscitation Council course, involving the teaching of theoretical knowledge and practical skills. The aim of the study was to evaluate the retention of theoretical knowledge and certain skills of EPLS providers 4 months after the course. ⋯ According to our findings, theoretical knowledge of the EPLS course uniformly declines, irrespective of the provider characteristics, whereas retention of certain skills is evident 4 months after the course.
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Review Case Reports
Sodium azide ingestion and secondary contamination risk in healthcare workers.
This study reports the follow-up of healthcare staff directly involved in managing a fatal sodium azide ingestion. Clinical staff directly involved with the case were contacted by telephone or in person. Data collected were age, sex, time in contact with the patient, time off work following the incident and whether or not this was because of physical complications of exposure. ⋯ Of these, five were men, median age was 39 years (range 22-52); four described being in close contact for greater than 60 min, three for 15-60 min and three for 5-15 min. Absence from work occurred in two cases for 1 day and several weeks, neither attributed to the physical effects of exposure. Our data do not support close contact with a sodium azide ingestion case as posing a high risk of significant postexposure complications in emergency service workers.