European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
To characterize prehospital delays in patients presenting with acute ST-elevation myocardial infarction to the emergency department of a tertiary hospital in Asia. A retrospective review of 273 patients with diagnosis of ST-elevation myocardial infarction; symptom to door (S2D) time was described in two ways, time from first onset of symptoms; and time from the onset of the worst episode to presentation at emergency department. The median first onset S2D time was 173 min (interquartile range 80-350 min); and median worst episode S2D time was 131 min (interquartile range 70-261 min). ⋯ There was no difference in S2D times for typical compared with atypical symptoms. A large proportion of patients experienced delay in seeking medical care after the onset of acute coronary symptoms. Self-transport was associated with delay.
-
To improve the quality and efficiency of our emergency surgical service. ⋯ Early consultant review and swift ultrasound assessment reduce admissions and patient stay. We have combined these factors in our emergency service and have delivered significant cost savings and improved care.
-
The objective of this study was to analyze the prehospital use of a Glidescope video laryngoscope (GSVL) due to anticipated and unexpected difficult airway in a helicopter emergency medical service setting in which emergency physicians (EP) are experienced anesthetists. Retrospective observational study and survey of the experiences of EP were conducted for more than a 3-year period (July 2007-August 2010). In 1675 missions, 152 tracheal intubations (TI) were performed. ⋯ In two patients, the EP required two attempts with GSVL to obtain a successful TI. Since the introduction of the GSVL, no other backup airway device was necessary. GSVL may be a valuable support instrument in the prehospital management of difficult airways in emergency patients.
-
Inadequate chest compressions during cardiopulmonary resuscitation (CPR) may be insufficient to provide the required blood flow to preserve critical organ function. The purpose of this study was to evaluate the influence of the CPR provider's physical fitness on the quality of chest compression and physiological changes during continuous chest compressions for 5 min. We also investigated the possible effects of rescuer's sex, weight, and height on the quality of CPR performed. ⋯ The results of this study suggest that a fitness program, such as muscle strength exercise for CPR providers, should be considered for improving survival from cardiac arrest.