European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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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.
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Randomized Controlled Trial Comparative Study
Comparison of two intraosseous devices in adult patients in the emergency setting: a pilot study.
To compare two intraosseous (IO) insertion devices in terms of safety and ease of use in patients who need urgent vascular access in the emergency setting following failed attempts for intravenous lines. ⋯ Both EZ-IO and BIG are shown to be reliable and safe methods for insertion of intravascular access in emergency conditions.
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Recognition of cardiac arrest (CA) during an emergency call leans on questions concerning CA symptoms and is correct in 50-83% of cases. If the heart rhythm could be recorded and analysed over a mobile phone or transmitted during the emergency call to the dispatch centre and analysed there, using software identical to one in an automated external defibrillator (AED), CA recognition could be more prompt. We investigated whether an AED can correctly analyse normal heart rhythms recorded within an area the size of a mobile phone. ⋯ ECGs can be analysed promptly with an AED within an area the size of a mobile phone. The most reliable recording position was vertical at the midsternum level.
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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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The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias. ⋯ Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.