European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
We investigated the effects of hyperoxemia on morbidity and mortality in acute cardiogenic pulmonary edema (ACPE). ⋯ Our exploratory study did not report effects on mechanical ventilation, median hospital LOS and in-hospital mortality from hyperoxemia compared to hypoxemic and normoxemic ED patients with ACPE. Further studies are warranted to prove or disprove our findings.
-
The loading force applied in infant external chest compression (ECC) has not been determined. The objective of this crossover study was to quantify the actual force involved in two-thumb (TT)-encircling hands and two-finger (TF) methods during infant cardiopulmonary resuscitation. ⋯ For infant CPR, the TT method involved greater loading force, lower fatigue, and higher overall ECC quality than the TF method. The optimal compression force is about 3.8-4.3 kg.
-
Observational Study
Clinical impression for identification of vulnerable older patients in the emergency department.
To investigate whether the clinical impression of vulnerability and the Dutch Safety Management Program (VMS), a screening instrument on four geriatric domains (activities in daily living, falls, malnutrition, delirium) are useful predictors of 1-year mortality in older patients in the emergency department. ⋯ The clinical impression of vulnerability is a simple dichotomous question which can be used as a first step in the identification of vulnerable older emergency department patients, whereas the more time-consuming VMS-screening is more specific for detection of vulnerability. The clinical impression of vulnerability is therefore useful in a busy emergency department environment where time and resources are limited.
-
Emergency department (ED) revisits had traditionally been used as a quality indicator, but focused more on the same hospital revisit (SHRV). Our study investigated the 72-hour ED revisits on SHRV and different hospital revisits (DHRV), and explored the predictors of DHRV. ⋯ About one in three ED revisits occurred in another hospital. SHRV rate alone would inevitably underestimate the true revisit rate. DHRV is associated with the hospital level and annual ED volume, and there is increased likelihood of DHRV if patient's index ED visit being a local hospital.
-
In the UK, the National Early Warning Score (NEWS) is recommended as part of screening for suspicion of sepsis. Is a change in NEWS a better predictor of mortality than an isolated score when screening for suspicion of sepsis?. ⋯ Persistently elevated NEWS, from prehospital through the ED to the time of ward admission, combined with an elevated ED lactate identifies patients with suspicion of sepsis at highest risk of in-hospital mortality.