European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Evaluation of an O2 treatment algorithm on the basis of current recommendations to reduce the number of patients unnecessarily treated with O2 in the Emergency Department of a tertiary hospital compared with the traditional application, and analysis of the use of O2. ⋯ The introduction of an O2 treatment algorithm in the Emergency Department reduced the number of patients treated with O2, and the nature and frequency of undesired effects was similar before and after the intervention.
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Emergency medical personnel are at risk of secondary contamination when treating victims of chemical-biological-radiological-nuclear incidents. Hence, it is crucial to train them on the appropriate management of patients involved in chemical-biological-radiological-nuclear incidents. Personal protective equipment (PPE) plays an important role in treating patients suffering from various types of poisoning. However, very few studies have examined whether the use of PPE impedes airway management in an emergency department setting. The present study evaluated the effect of PPE on physicians' performance of emergency airway management using mannequins. ⋯ Protective equipment had no effect on physicians' emergency airway placement time. The effect of wearing PPE is limited if postintubation care is excluded from the evaluation. Furthermore, intubation experience influenced participants' preferred approach for airway management.
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Randomized Controlled Trial
e-Learning versus lecture-based courses in ECG interpretation for undergraduate medical students: a randomized noninferiority study.
An ECG is pivotal for the diagnosis of coronary heart disease. Previous studies have reported deficiencies in ECG interpretation skills that have been responsible for misdiagnosis. However, the optimal way to acquire ECG interpretation skills is still under discussion. Thus, our objective was to compare the effectiveness of e-learning and lecture-based courses for learning ECG interpretation skills in a large randomized study. ⋯ Our randomized study showed that the e-learning course is an effective tool for the acquisition of ECG interpretation skills by medical students. These preliminary results should be confirmed with further multicenter studies before the implementation of e-learning courses for learning ECG interpretation skills during medical school.
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The triage of trauma patients is based on patient-given information. The aim of the study was the accuracy of pain intensity, subjective functional impairment, trauma history, and clinical examination in identifying patients with fractures. ⋯ Fracture diagnosis based only on patient opinion or subjective functional impairment can be misleading. Pain intensity needs further investigation for its role in fracture detection.
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In previous studies including patients with suspected cardiac chest pain, those who had acute myocardial infarction (AMI) reported more severe chest pain than those without AMI. However, many patients with AMI present with very mild pain or discomfort. We aimed to investigate whether peak pain severity, as reported by patients in the Emergency Department, has any potential role in the risk stratification of patients with suspected cardiac chest pain. ⋯ Pain score has limited diagnostic value for AMI. Scores should guide analgesia but shift the probability of AMI very little, and should not guide other clinical management.