European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aims of our study are to evaluate the use of computed tomographic scan of the head (CT-head) in patients with altered mental status (AMS) presenting to the Emergency Department (ED) and to identify clinical features associated with an abnormal CT-head result. ⋯ Our study identified important risk factors for an abnormal CT-head result which can be used in future research to establish a guideline for rational ordering of the test in AMS patients.
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The objective of this study was to assess whether the number of syncope attendances to the Emergency Department is related to daily temperature and humidity, or time of the day, day of the week, month or season of the year. All adult patients presenting with syncope over a 1-year period between 1 March 2007 and 29 February 2008 were enrolled. A circadian pattern of syncope attendances exists, peak attendance was between 10 : 00 and 16 : 00 h, especially in those aged above 65 years (P<0.001). ⋯ A trend was found towards more attendances between December and May. One hypothesis for this is differences between indoor and outdoor temperatures. Public health campaigns could be targeted towards elderly patients to ensure that they are aware of the increased risk of syncope on waking and also on transferring from cold to warm environments.
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Comparative Study
Emergency Medical System response to out-of-hospital cardiac arrest in Milan, Italy.
The objective of this study was to investigate how rapidly the Emergency Medical System provides life support to patients suffering out-of-hospital cardiac arrest in Milan, Italy. The study population included 1426 consecutive participants with out-of-hospital cardiac arrest between January 2007 and October 2008. The mean age was 72.7 years. ⋯ The mean time interval from collapse-to-first shock was 18.67+/-5.37 min. The mean Emergency Medical System unit response time interval was 7.07+/-3.14 min; time elapsed from arrival-to-first CPR was 7.75+/-4.32 min. In conclusions, the dispatch to arrival and dispatch to CPR intervals are comparable with those reported in other large urban areas, but the time from arrival-to-first CPR was longer than recommended by current guidelines.
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The objectives of the Pediatric Emergency Research Network's (PERN) meeting were to (i) learn about each of the participating network's missions, goals, and infrastructure; (ii) share important contributions that each network has made to the creation of new knowledge; (iii) discuss 'best practices' to improve each network's effectiveness and (iv) explore the potential for a collaborative research project as proof-of-concept that would help promote quality of care of the acutely ill and injured child/youth globally. ⋯ Several members of PERN will be gathering at the International Conference on Emergency Medicine in Singapore, where the group will be presenting information about the H1N1 initiative. The PERN group is planning to bring together all five networks later in 2010 to discuss future global collaborations.
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Patients with acute heart failure (AHF) are frequently evaluated in the Emergency Departments (ED) and discharged from their observation units (OU) without hospital admission. We examined direct discharge rates from the ED OU, risk factors for returning to the ED, and returning and mortality rates. ⋯ One-third of the patients consulting at the ED for an episode of AHF can be directly discharged from the OU of ED, with relatively low rates of reattendance (26.7%) and mortality (4.7%). Emergency physicians should be especially cautious discharging patients with functional dependence because they are at increased risk of returning.