European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Observational Study
Telestroke: rapid treatment of acute ischemic stroke patients using telemedicine in a Singapore emergency department.
In recent years, telemedicine technology has allowed hospitals without an in-house neurology service access to 24-h neurology consultation from specialized centers, thus paving the way for these hospitals to offer thrombolysis treatment for stroke patients. This article will describe the experience of the study hospital's emergency department (ED) in its use of telemedicine technology to facilitate the rapid treatment of acute ischemic stroke patients. ⋯ Telemedicine is an invaluable tool that enables hospitals without 24-h onsite neurology service to offer emergency thrombolysis to eligible stroke patients, who otherwise will not be able to benefit from this therapy.
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Secondary hazards are an important consideration when dealing with both self-poisoned and chemically contaminated patients. Secondary exposure of hospital staff following the admission of a poisoned patient is relatively rare but potentially serious. Risks usually arise from chemical conversion of a deliberately ingested toxic substance and subsequent offgassing, but there may be toxic substances on the victim or their clothing. ⋯ This paper presents a narrative review that considers some of the more commonly encountered toxic chemicals and situations that may present secondary hazards in hospitals. Risks to staff can be lowered by reducing the potential for, and duration of, exposure wherever possible. Good communication with the first responders at the scene, consultation with experts, decontamination and use of personal protective equipment, together with regular training, can minimize risks in the hospital environment.
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Randomized Controlled Trial
A telephone-based case-management intervention reduces healthcare utilization for frequent emergency department visitors.
A small group of frequent visitors to emergency departments accounts for a disproportional large number of total emergency department visits. Previous interventions in this population have shown mixed results. ⋯ Our results indicate that the nurse-managed telephone-based case-management intervention represents a possible strategy to improve care for frequent emergency department users as well as decrease outpatient visits, admission days and healthcare costs.
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Randomized Controlled Trial
Evaluation of advanced airway management in absolutely inexperienced hands: a randomized manikin trial.
Endotracheal intubation (ETI) and basic ventilation techniques (i.e. mouth-to-mouth/nose, bag-valve-mask ventilation) require skills and training. As an alternative, supraglottic airway devices (SAD) are efficient and technically easy to insert. We therefore evaluated the time to ventilation, success rate, and skill retention for various airway management approaches by medical laypersons using a manikin model. ⋯ A variety of SAD all proved to reliably secure airways quickly, even in the hands of complete novices. The SAD were much more effective than ETI, which often failed, and were even superior to mouth-to-mouth ventilation. SAD may thus be an appropriate first-line approach to field ventilation.
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We aimed to investigate whether there was an unmet need for paediatric procedural pain management and/or sedation in Danish emergency departments (EDs). Cross-sectional survey of the 21 emergency hospitals in Denmark. ⋯ There is an unmet need for paediatric procedural pain management in Scandinavian EDs. Scandinavian guidelines on paediatric pain management and sedation in the ED are needed.