European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Maxillofacial trauma is common and may lead to haemorrhage that is associated with actual or impending airway compromise. This study briefly discusses the aetiology of midfacial haemorrhage and describes a simple effective technique of midface splintage for haemorrhage control, which may be applied in the prehospital and emergency environments. This technique has been used successfully by the London Helicopter Emergency Medical Service.
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Patients triaged in category 5 of the Emergency Severity Index (ESI) do not need any resources before discharge from the emergency department (ED). We studied the characteristics of these patients and focused on those who were admitted or sent to the outpatient department after their ED visit. ⋯ Although younger patients and women were more likely triaged in ESI 5, patients within this category who were admitted or sent to the outpatient department were more likely elderly and referred patients. Being admitted or sent to the outpatient department and triaged in ESI 5 indicates undertriage. Revision of the system is required to properly account for these patient groups.
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Comparative Study
Instructor retraining and poster retraining are equally effective for the retention of BLS and AED skills of lifeguards.
More than a million people in the USA and Europe suffer a sudden cardiac arrest each year. Thousands of people have to be trained in delivering help in such a situation. This cluster-randomized study compared two refresher training methods for basic life support and use of an automated external defibrillation: a traditional instructor-led course, and self-instruction by poster. ⋯ Refresher self-training by the use of a poster was as effective as, and more flexible than, scheduled, instructor-led refresher training.
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Comparative Study
Targeted wire-guided chest tube placement: a cadaver study.
Chest tube thoracostomy is a standard procedure for pleural fluid and air drainage. The aim of this study is to compare the success rate of the targeted tube thoracostomy using two different techniques: a targeted wire-guided (TWG) technique and a classical surgical (CS) technique. ⋯ A higher success rate was achieved with the TWG than with the CS thoracostomy technique.
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We included 685 consecutive previously healthy well appearing infants younger than 3 months with fever without known source admitted to an Emergency Department without routinely performing lumbar punctures (LP). LP was performed in 198 infants. Of these, 36 (18.1%) showed pleocytosis. ⋯ It is unnecessary to perform a LP routinely on infants over 1 month of age. The decision to perform the LP in previously healthy and well appearing infants with fever without known source attended by an experienced paediatric emergency physician can be individualized with no subsequent adverse outcomes. This approach may lead to under-diagnosing nonbacterial meningitis.