European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Accuracy of prehospital triage of trauma patients by emergency physicians: a retrospective study in western Switzerland.
Accurate identification of major trauma patients in the prehospital setting positively affects survival and resource utilization. Triage algorithms using predictive criteria of injury severity have been identified in paramedic-based prehospital systems. Our rescue system is based on prehospital paramedics and emergency physicians. The aim of this study was to evaluate the accuracy of the prehospital triage performed by physicians and to identify the predictive factors leading to errors of triage. ⋯ Physicians using clinical judgement provide effective prehospital triage of trauma patients. Only a few factors predicting errors in triage process were identified in this study.
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Comparative Study
Predictive factors for positive coronary angiography in out-of-hospital cardiac arrest patients.
Coronary angiography is often performed in survivors of out-of-hospital cardiac arrest, but little is known about the factors predictive of a positive coronary angiography. Our aim was to determine these factors. ⋯ Among the factors identified, diabetes and a history of coronary artery were strong predictors for a positive coronary angiography, whereas ST segment elevation was not as predictive as expected.
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Comparative Study
Physician experience in addition to ACLS training does not significantly affect the outcome of prehospital cardiac arrest.
Little data exists on whether the physicians' skills in responding to cardiac arrest are fully developed after the advanced cardiac life support (ACLS) course, or if there is a significant improvement in their performance after an initial learning curve. ⋯ In this study, resuscitative experience of the physician did not have a significant effect on survival suggesting that experience does not significantly add to the current ACLS training in responding to ventricular fibrillation/ventricular tachycardia. More studies are needed.
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Comparative Study
Early in-hospital management of out-of-hospital cardiac arrest in Scotland: a national survey.
Guidelines recommend the use of mild therapeutic hypothermia (MTH) and percutaneous coronary intervention (PCI) in the early post-resuscitation management of select out-of-hospital cardiac arrest (OHCA) cases. This study aims to assess the current use of MTH and PCI in Scottish Emergency Departments (ED) and Intensive Care Units (ICU). We conducted a questionnaire survey of all the Scottish Emergency Medicine Consultants, EDs and ICUs. ⋯ The use of MTH after OHCA appears to be widespread, although it is infrequently initiated in the ED. The utilization of PCI in OHCA management has yet to be widely established. Increased awareness may increase the use of promising therapies such as MTH and PCI following OHCA to save lives.
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Comparative Study
Acute severe asthma: performance of ventilator at simulated altitude.
Exacerbation of asthma can be seen during air transport. Severe patients, not responding to conventional therapy, require ventilator support. We evaluated the performance of two transport ventilators, built with turbine technology, the T-birdVSO2 and the LTV-1000, for use during aeromedical evacuation of acute severe asthma. We have assessed the ability of both the ventilators to deliver to an acute severe asthma model a tidal volume (Vt) set at different simulated altitudes, by changing the ambient air pressure. ⋯ The accuracy of Vt delivery was superior with the LTV-1000 than with the T-birdVSO2, but the higher delivered Vt of the LTV-1000 are likely to be more harmful than lower delivered Vt of the T-birdVSO2.