European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Needlestick and 'sharps' injuries among those working with animals are a significant, under-reported and often ill-understood problem. Many patients present initially to Emergency Departments, where their potential to cause local and systemic infections and injury, zoonoses, allergic or anaphylactic reactions and death may be unrecognized. Increased awareness of the possibility of adverse effects and the consequences of these specific injuries is essential.
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Randomized Controlled Trial Observational Study
Bedside lung ultrasound for monitoring the effectiveness of prehospital treatment with continuous positive airway pressure in acute decompensated heart failure.
The aim of this pilot study was to determine the usefulness of prehospital lung ultrasound in monitoring the effectiveness of treatment with continuous positive airway pressure (CPAP) versus standard therapy in patients with acute decompensated heart failure (ADHF). ⋯ Bedside lung ultrasound is a reliable monitoring tool in a prehospital emergency setting and findings from lung ultrasound scans correspond with improved hemodynamic parameters in patients with ADHF treated with CPAP compared with standard therapy only.
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Comparative Study
Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.
Gastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. ⋯ The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.
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Comparative Study Observational Study
Urgent carotid duplex and head computed tomography versus ABCD2 score for risk stratification of patients with transient ischemic attack.
The aim of the study was to prospectively compare the prognostic value of ABCD score, urgent carotid ultrasound (CUS), and unenhanced head computed tomography (UHCT) in patients presenting to the emergency department with transient ischemic attack (TIA). ⋯ Simple imaging tests showed added prognostic value to ABCD score in TIA patients. Urgent CUS together with UHCT should be performed in all TIA patients regardless of ABCD score.
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Observational Study
The predictive validity of RETTS-HEV as an acuity triage tool in the emergency department of a Danish Regional Hospital.
The Rapid Emergency Triage and Treatment System - Hospital Unit West (RETTS-HEV) is a triage system used in the emergency department (ED) in Herning, Denmark, since 2010. It categorizes patients according to priority and defines a time limit on how long patients can wait before being seen by a doctor depending on the severity of their condition. The purpose of this study was to determine the predictive validity of RETTS-HEV by measuring the association between triage scores and outcomes such as the admission rate, the length of stay (LOS), and mortality. ⋯ RETTS-HEV was found to be closely related to all examined outcomes, and therefore useful in the risk stratification of ED patients.