European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Admission with severe sepsis is associated with an increased short-term mortality, but it is unestablished whether sepsis severity has an impact on intermediate-term and long-term mortality following admission to an acute medical admission unit. ⋯ Patients admitted with community-acquired sepsis showed high intermediate-term mortality, increasing with sepsis severity. Long-term mortality was increased two-fold compared with sepsis-free individuals, but might be explained by unmeasured confounding. Further, long-term mortality was unrelated to sepsis severity.
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Comparative Study
Prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest: a retrospective study in Tyrol, Austria.
The aim of this study is to describe the prehospital management and outcome of avalanche patients with out-of-hospital cardiac arrest in Tyrol, Austria, for the first time since the introduction of international guidelines in 1996. ⋯ CPR is continued to hospital admission in patients with short burial and asphyxial cardiac arrest, but withheld or terminated at the scene in patients with long burial and possible hypothermic cardiac arrest. Insufficient transfer of information from the accident site to the hospital may partially explain the poor outcome of avalanche victims with out-of-hospital cardiac arrest treated with emergency cardiac care.
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Multicenter Study Observational Study
Duplex ultrasound in the early diagnosis of acute mesenteric ischemia: a longitudinal cohort multicentric study.
Acute mesenteric ischemia (AMI) is a life-threatening condition requiring time-dependent treatment; thus, early recognition may improve outcomes. We hypothesized that clinician-performed mesenteric vessels duplex ultrasound (DUS) could facilitate early identification of patients with AMI in high-risk patients presenting with abdominal pain. ⋯ In this single-operator pilot study, mesenteric vessel DUS was performed successfully in the Emergency Department, with a high proportion of diagnostic images obtained. A normal SMA PSV was associated with a low risk of occlusive AMI.
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Comparative Study
Does it matter who places the intravenous? An inter-professional comparison of prehospital intravenous access difficulties between physicians and paramedics.
Depending on the specific national emergency medical systems, venous cannulations may be performed by physicians, paramedics or both alike. Difficulties in the establishment of vascular access can lead to delayed treatment and transport. Our study investigates possible inter-professional differences in the difficulties of prehospital venous cannulation. ⋯ Our study shows that venous cannulation is well established among paramedics. It presents itself with similar difficulties across medical professions. Not the numerous specific circumstances of prehospital emergency care, but universal factors inherent to the task will influence the success at venous catheterization.
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Multicenter Study
How do patients with chest pain access Emergency Department care?
It is important that patients with symptoms of acute coronary syndrome receive appropriate medical care as soon as possible. Little is known about the preadmission actions that patients with chest pain take before arrival at the Emergency Department (ED). ⋯ In Belgium, the GP is still the first professional to be contacted for most patients. Other patients initially rely on their partner, family or friends when symptoms emerge. Too often, patients with chest pain rely on other transport to get to the ED instead of calling the Emergency Medical Services. This study included only patients who ultimately attended the ED.