European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Comparative Study
Emergency airway management by paramedics: comparison between standard endotracheal intubation, laryngeal mask airway, and I-gel.
The aim of this study was to investigate whether briefly trained paramedics would be able to successfully intubate by endotracheal intubation (ETI) and using the laryngeal mask airway (LMA) and the I-gel in a manikin model. After the completion of a questionnaire, a brief educational session, and presentation of ETI, LMA, and I-gel, 72 paramedics were randomly allocated to intubate an adult manikin. ⋯ In addition, the mean insertion time values were significantly affected by the accuracy of the answers to the theoretical questions (P<0.05 for all questions). Paramedics should lay greater emphasis on airway management using supraglottic devices, especially I-gel because of its shorter time of insertion.
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The objective of this study was to describe the type of interconsultations carried out in the Emergency Department (ED) to hospital specialists and analyze their pattern over time. ⋯ The study of interconsultations allows us to identify areas of lesser autonomy of emergency physicians. Changes in the pattern of these interconsultations over time may reflect both learning processes and changes in the healthcare circuits in the ED.
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It is known that visual estimation of blood loss is inaccurate independently from experience and qualification of rescuers or members of hospital staff. There is no information available about the size of a puddle of blood for a given amount of blood depending on the surface. This pilot study evaluated the size of blood puddles on various surfaces. ⋯ The size of puddles of blood depended strongly on the type of surface. Up to 13 times larger blood puddles were found on hard and nonabsorbant surfaces (PVC, concrete) than on absorbant surfaces such as carpet or forest soil.
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Observational Study
Blood culture diagnostic yield in a paediatric emergency department.
Blood culture (BC) is one of the most commonly used microbiological tests in the paediatric emergency department (PED) despite its lack of immediate diagnostic utility. Our objectives were to uncover the reasons for BC in the PED, to review adherence to the current protocol for this technique, and to analyse the diagnostic yield (DY) of BC in localized bacterial infections. ⋯ FWS is the main reason for BC in the PED. One-quarter of the BCs were not indicated, with the DY null in these cases. Due to the low DY in certain localized bacterial infections, a strict individualized ordering of BC in these cases should be considered.
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The aim of this study was to assess the walkout rate and to identify influencing patient and visit characteristics on walkout. Furthermore, we assessed the reasons for leaving and medical care needs after leaving. ⋯ The average observed daily walkout rate was 1.4 patients over the 4-month period. In general, walkouts are self-referrals with lower urgent complaints, arriving during the evening or night shift or during crowded conditions. Most walkouts leave because of perceived long waiting times.