European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study Observational Study
The management of cellulitis in emergency departments: antibiotic-prescribing practices and adherence to practice guidelines in Ireland.
There is a lack of evidence to guide the management of cellulitis in the emergency department (ED). The primary aim of this study was to characterize antibiotic-prescribing practices for the treatment of cellulitis in Irish EDs. Secondary aims were to identify patient variables associated with the prescription of intravenous (i.v.) antibiotics and to describe the utility of three published guidelines for the management of cellulitis in the ED. ⋯ In Ireland, current prescribing practices for CREST 1 and modified CREST 1 and 2 patients are poorly adherent to guideline recommendations.
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Wrist injuries are common, and there is often diagnostic uncertainty following normal initial radiographs when there is ongoing clinical suspicion of a scaphoid fracture.The aims of this study were to define the problem in our hospital, and to identify current practice relating to the management of patients with clinically suspected scaphoid injury across hospitals in England. ⋯ This is still considerable variability in the way these patients are managed in England. Further work needs to be undertaken to establish the most appropriate way to manage patients with wrist injuries with ongoing clinical suspicion of scaphoid fracture.
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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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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.