European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Gunshot injuries to the chest often require urgent admission to the nearest hospital, because of the cardiorespiratory status, transfer to a hospital without a cardiothoracic unit might be unsafe. In this case, a male patient was transferred to the nearest hospital on being shot through the heart. ⋯ We report our treatment regime for thoracic injuries and the specific management of this patient. We conclude that every hospital with an accident and emergency department has to be prepared for such an injury and that operative management is possible without cardiopulmonary bypass.
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This prospective study was conducted in three mobile emergency and intensive care units. ⋯ More training and greater diffusion of the protocols are required, especially with regard to doctors who intervene intermittently.
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Severe injury is the leading cause of death among the young. Trauma systems have improved management of the severely injured and increased survival rates, but there is no level-1 evidence of advanced prehospital trauma care. Advanced prehospital trauma care prolongs on-scene time, which may imply a risk of significant delay in definitive trauma care. The aim of this study was to evaluate on-scene time and influence of (1) the presence of an anaesthesiologist on-scene, (2) prehospital intubation, (3) entrapment, and (4) injury severity. ⋯ The presence of an anaesthesiologist prolonged the median on-scene time by 1 min and in cases of prehospital intubation by 7.5 min. This result was no different from the prolongation caused by entrapment.
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Bronchiolitis is the most common serious, acute viral infection in infants. Besides the diagnostic and treatment challenges, the appropriate time and the need of hospitalization remain unanswered. We wonder whether clinical predictors such as age less than 6 months, respiratory frequency more than 45 breaths per minute and oxygen saturation less than 95% could be of any help in assessing the severity of the disease and the need for admission. ⋯ Oxygen saturation less than 95%, respiratory frequency more than 45 breaths per minute and age less than 6 months in respiratory-distressed infants are important parameters to predict the need for admission and emphasize the severity of bronchiolitis.
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Rapid retrieval of information, including drug treatment options, is critical to emergency department practice. ⋯ Personal digital assistants are feasible in an academic emergency department and change management more often than texts. EMRs accessed personal digital assistants more often than paper texts. Patient perceptions of physicians who use personal digital assistants are neutral or favorable.