European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Multicenter Study Observational Study
The utility of copeptin in the emergency department for non-ST-elevation myocardial infarction rapid rule out: COPED-MIRRO study.
To evaluate whether the addition of copeptin measurement to the first troponin determination allows non-ST-elevation acute myocardial infarction to be ruled out in patients consulting the emergency department (ED) for nontraumatic chest pain (NTCP) suggestive of acute coronary syndrome (ACS) whose first electrocardiogram and troponin determination are nondiagnostic, thereby avoiding a second determination of troponin and shortening ED stay. ⋯ The determination of copeptin on arrival to the ED in patients with NTCP suggestive of ACS, in addition to routine troponin determination, does not allow the presence of myocardial infarction to be ruled out quickly and safely and does not avoid ED stay for a second determination of troponin.
-
Comparative Study
Comparison of rocuronium and succinylcholine on postintubation sedative and analgesic dosing in the emergency department.
Rocuronium and succinylcholine are both commonly used neuromuscular blockers for rapid sequence intubation in the emergency department (ED). The objective of this study was to determine if patients who receive rocuronium are more likely to receive lower doses of postintubation sedatives and analgesics compared with patients who receive succinylcholine. ⋯ Patients who receive rocuronium are more likely to receive lower doses of sedative and analgesic infusions after intubation. This may place them at risk of being awake under paralysis.
-
Multicenter Study Comparative Study
Use of noninvasive positive pressure ventilation in emergency departments of public and private hospitals in Lebanon.
Noninvasive positive pressure ventilation is increasingly being used in emergency departments across Europe and North America. To our knowledge, no similar data are available from other countries. The aim of this study is to describe the current use of noninvasive positive pressure ventilation in the emergency departments of Lebanese hospitals. ⋯ Face mask is the most used patient interface. The use of uniform protocols and training is lacking. Noninvasive positive pressure ventilation in Lebanese emergency departments is underused, with significant potential for improvements in its current practice.
-
Comparative Study
Effects of a standard operating procedure on prehospital emergency care of patients presenting with symptoms of the acute coronary syndrome.
To determine whether a standard operating procedure (SOP) for prehospital management of patients with the acute coronary syndrome (ACS) improves the quality of patient care in terms of adherence to treatment guidelines of the European Society of Cardiology. Among a total of 1025 patient medical records collected from a period before and after the introduction of the SOP, 269 records included the working diagnosis of ACS and were then reviewed for guideline adherence. ⋯ The percentage of cases in whom sublingual nitrate (55.2 vs. 66.7%) or intravenous morphine (26.9 vs. 43.0%) was administered without contraindications was higher after the SOP had been introduced. Therefore, the use of an SOP in prehospital emergency medicine can partly improve the adherence to guideline recommendations for the treatment of patients with ACS.
-
Comparative Study Observational Study
Comparison of the trauma and injury severity score and modified early warning score with rapid lactate level (the ViEWS-L score) in blunt trauma patients.
The aim of this study was to compare the predictive value of the VitalPAC Early Warning Score-lactate (ViEWS-L) score with that of the trauma and injury severity score (TRISS), which is a pre-existing risk scoring system used in trauma patients. ⋯ The prognostic value of the ViEWS-L score in terms of discrimination was better than that of TRISS in the blunt trauma patients admitted to the emergency department with an injury severity score of 9 or higher, and the ViEWS-L score showed good calibration.