European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Oral, axillary, and tympanic temperature measurements in older and younger adults with or without fever.
The purpose of this study was to compare the results of body temperature obtained by a nurse with standard mercury thermometers from axillary and oral regions with the results of infrared tympanic thermometer in febrile and afebrile patients/in older and younger adults with or without fever, and to determine whether tympanic measures are suitable for use in the elderly population. ⋯ Tympanic thermometers seem to be optimal for use with the elderly population. Owing to the ease of application, safety, and tolerability in the elderly; their use in routine practice seems to be advantageous. Higher reading of tympanic measurements may lead to a suspicion of infection, especially in the elderly, which may be helpful in clinical treatment in this age group.
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Case Reports
Management of acute gastrothorax with respiratory distress: insertion of nasogastric tube as a life saving procedure.
An 86-year-old patient was transferred to our institution with acute respiratory distress. A tension pneumothorax was suspected, but needle decompression was unsuccessful. Instead of the suspected pneumothorax, the chest radiograph revealed a large 'tension gastrothorax'. ⋯ Nasograstric tube insertion is a life saving procedure to be undertaken without delay. However, tension gastrothorax is a rare entity. Therefore, if tension pneumothorax is suspected, needle decompression should not be delayed.
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The modified Early Warning Score (mEWS) is a triage instrument that promises to predict patient disposition and clinical outcome in emergency departments (EDs). We investigated whether mEWS can predict death, hospital admission, intensive care unit (ICU) admission, and in-hospital deaths in a Turkish setting. ⋯ We conclude that scores on the mEWS predict ICU admission as well as ICU and in-hospital deaths.
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Objective of this study is to determine whether the formulation of standard operating procedures (SOPs) and their incorporation in a trauma pathway are associated with an improvement of trauma treatment process. ⋯ SOP incorporation in a trauma pathway shortens the total stay in the emergency room, resuscitation time and the time to achieve definitive diagnosis in multiple trauma patients. Thus, it can be concluded that organization and timing of trauma treatment steps help in improving the quality of trauma treatment process.
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No European airway management guidelines are currently specific to patients with cervical spinal cord injury (CSCI). The objectives of this study were to determine the clinical practice of European emergency physicians and anaesthesiologists regarding airway management in patients with CSCI. A questionnaire survey was completed by the participants of the fourth European Congress on Emergency Medicine regarding the preferred intubation techniques and the relevant skills, as well as airway management manoeuvres that, in the physician's opinion, caused the least and the greatest cervical spine movement. ⋯ However, most of the physicians who indicated the use of the fibreoptic bronchoscope as their preferred technique, were not skilled in its use. Furthermore, two-thirds of the respondents did not recognise that mask ventilation causes considerable cervical spine movement. Emergency physicians need better training in airway management to anticipate problems in patients with CSCI.