European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study Observational Study
Bradykinin-mediated angioedema: factors associated with admission to an intensive care unit, a multicenter study.
Bradykinin-mediated angioedema is characterized by transient attacks of localized edema of subcutaneous or submucosal tissues and can be life-threatening when involving the upper airways. The aim of this study was to determine the features of acute attacks that might be associated with admission to an ICU. ⋯ Upper airway involvement is an independent risk factor for ICU admission. Corticosteroid use, which is an ineffective treatment, and C1-inhibitor concentrate use are factors for ICU admission. The presence of upper airway involvement should be a warning signal that the attack may be severe.
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Comparative Study Observational Study
A comparison of a formal triage scoring system and a quick-look triage approach.
Emergency Department (ED) triage systems have become increasingly comprehensive over time, requiring ever more resources such as nursing time and computer support. There are very few studies that have looked at whether this increased complexity results in improved performance. ⋯ TNs assigning triage scores to ED patients on arrival, using only chief complaint and observation, were statistically comparable to scores assigned utilizing a resource-intense, comprehensive triage system, but clinically significant discrepancies were identified.
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Observational Study
Self-referrals in a Dutch Emergency Department: how appropriate are they?
Self-referred visits account for an average of 30% of all Emergency Department (ED) visits in the Netherlands. Some of these are considered inappropriate, because patients receive care that a GP can provide. Worldwide, studies have used various methods to determine the proportion of inappropriate visits by self-referred patients, resulting in diverging percentages. The aim of this study was to find a reliable percentage of appropriate visits to the ED by self-referred patients in the Netherlands. ⋯ The percentage of appropriate ED visits by self-referred patients in the Netherlands ranges from 48.1 to 58.8%, as determined using two different methods.
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Observational Study
Ethically justified treatment limitations in emergency situations.
Medical emergency teams (METs) implement do not attempt cardiopulmonary resuscitation (DNACPR) orders and other limitations of medical treatment (LOMTs) in hospitals regularly. However, METs operate in emergency situations with limited or no patient information at the scene. We aimed to study the medical ethics of LOMTs implemented in in-hospital emergency situations. ⋯ LOMTs were implemented in a decent and ethically justified manner in emergency situations following the code of conduct recommended by guidelines, even though MET operated under highly suboptimal circumstances for end-of-life care planning.