European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Recognition of cardiac arrest (CA) during an emergency call leans on questions concerning CA symptoms and is correct in 50-83% of cases. If the heart rhythm could be recorded and analysed over a mobile phone or transmitted during the emergency call to the dispatch centre and analysed there, using software identical to one in an automated external defibrillator (AED), CA recognition could be more prompt. We investigated whether an AED can correctly analyse normal heart rhythms recorded within an area the size of a mobile phone. ⋯ ECGs can be analysed promptly with an AED within an area the size of a mobile phone. The most reliable recording position was vertical at the midsternum level.
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The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias. ⋯ Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.
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Multicenter Study
Agreement between ambulance and hospital records for information promoting urgent stroke treatment decisions.
Rapid decision-making during acute stroke care can improve outcomes. We wished to assess whether crucial information to facilitate decisions is routinely collected by emergency practitioners before hospital admission. ⋯ In a retrospective cohort of stroke patients admitted by emergency ambulance, standard practice did not consistently result in prehospital documentation of information that could promote rapid treatment decisions. Training emergency practitioners and/or providing clinical protocols could facilitate early stroke treatment decisions, but prehospital information availability is likely to be a limiting factor.
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Blood cultures are performed in the emergency room when sepsis is suspected, and a cohort of patients is thereby identified. The present study investigated the outcomes (mortality and length of hospital stay) in this group following an emergency medical admission. ⋯ A clinical decision to request a blood culture identified a subset of emergency admissions with markedly worse outcomes. This patient cohort warrants close monitoring in the emergency setting.
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Randomized Controlled Trial Multicenter Study Comparative Study
Weaker compressions after night shift? The WeCAN manikin study.
To assess whether the quality of chest compressions (CC) differs before and after a night shift. We carried out a cluster randomized study in three Emergency Departments and three ICUs in Paris, France. Physicians were assessed on a control day and immediately following after a night shift. ⋯ The proportion of CC with a depth greater than 50 mm was similar on a control day and after a night shift [52% in both groups, mean difference of 0 (95% confidence interval: -17 to 17)]. Other indicators of CC quality were unchanged after a night shift, except for the mean depth of CC (51 vs. 48 mm, P=0.01). We report in our sample that the quality of CC after a night shift is not inferior to a control day.