European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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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.
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Randomized Controlled Trial
Chest compression using the foot or hand method: a prospective, randomized, controlled manikin study with school children.
Maintaining a chest compression depth of 5 cm or more as specified by resuscitation guidelines is difficult. Historical studies have shown an advantage of the foot method (FM) over the hand method (HM) in participants weighing less than 50 kg. Because of the fact that the importance of chest compression is increasing from guideline to guideline, the FM technique had not been evaluated conclusively and worldwide resuscitation is taught to school children, we investigated whether school children achieved a higher quality of chest compression with the FM than with the HM. ⋯ The FM of applying chest compression did not result in a more accurately delivered compression depth compared with the HM for children and adolescents, irrespective of body weight.
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We investigated whether there are differences in emergency department (ED) patient management associated with emergency physician (EP) sex, specifically in terms of ordering investigations and hospital admissions. ⋯ Female EPs order more investigations and admit more patients, although from our results the reason for this is unclear, and the impact on healthcare effectiveness and patient outcome is unknown.
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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.