European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Emergency medicine is a fast-growing medical profession. Nevertheless, the clinical activities emergency physicians (EPs) carry out and the responsibilities they have differ considerably between hospitals. This article addresses the question how the role of EPs is shaped and institutionalized in the everyday context of acute care in hospitals. ⋯ In contemporary literature it is often argued that the role and status of EPs should be enhanced by strengthening regulation and improving training programs. This article shows that attention should also be paid to the more subtle everyday processes of role development.
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The aims of this study were to assess the influence of sex and body position on external chest compression (ECC) to a manikin by Chinese nurses and to determine the relationship between rescuer's predicted VO2max and ECC depth. ⋯ Irrespective of sex, the K-position appears to facilitate effective ECC. The relationship between aerobic fitness of female nurses and their ability to perform effective cardiopulmonary resuscitation warrants further investigation.
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Comparative Study
Time delay to surgery for appendicitis: no difference between surgical assessment unit and emergency department.
In Denmark, emergency departments (EDs) are replacing acute surgical and medical units. The aim of this study was to compare the trajectory of patients undergoing surgery on the suspicion of appendicitis in a surgical assessment unit (SAU) and EDs with an observation unit, respectively. The primary outcome measure was the time from hospital arrival-to-decision for surgery. ⋯ The introduction of EDs with observation units did not influence time to decision for surgery, but more blood tests were performed.
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Emergency departments (EDs) constitute a central part of the healthcare system that receives patients with complaints of varied urgency. A long length of stay (LOS) in the ED is associated with crowding, low patient satisfaction and poor patient outcomes. Therefore, it is important to understand the key drivers and patient characteristics associated with long LOS. ⋯ Long LOS in the ED is associated with both patient and organizational characteristics and the elderly are at particular risk of long LOS. These insights may be used to improve patient outcome metrics and enhance ED efficiency. Further studies are needed to clarify the role of additional factors as well as the causality of the studied factors.
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Observational Study
Telemetry-assisted early detection of STEMI in patients with atypical symptoms by paramedic-performed 12-lead ECG with subsequent cardiological analysis.
ECG is an essential diagnostic tool in patients with acute coronary syndrome. We aimed to determine how many patients presenting with atypical symptoms for an acute myocardial infarction show ST-segment elevations on prehospital ECG. We also aimed to study the feasibility of telemetric-assisted prehospital ECG analysis. ⋯ Telemetry-assisted 12-lead ECG analysis in a prehospital setting may lead to earlier detection of ST-elevation myocardial infarction in patients with atypical symptoms. Thus, a 12-lead ECG should be considered in all prehospital patients both with typical and atypical symptoms.