European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Delayed pericardial tamponade (PT) after penetrating heart trauma is now a rare condition as a result of advances in medical and surgical management. We report the case of a 32-year-old man with delayed PT after a stab wound from a knife. ⋯ After an uneventful initial course, the patient developed acute PT, which required emergency surgery. A thrombus was discovered over a laceration in the mid-segment of the left anterior descending artery and a simple suture was performed.
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Volunteer citizens were recruited to perform simulated emergency calls, and the expressions and content of these telephone calls were analysed to examine risk factors associated with the success or failure of communication. ⋯ In developing a 'protocol for emergency call triage' to achieve a high rate of successful emergency communications, an analysis of expressions using simulated patients is useful.
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Case Reports
Delayed perforation of right ventricle with cardiac tamponade: a complication of pacemaker implantation.
We report a case of delayed cardiac tamponade that resulted from pacemaker implantation in the emergency room of a large urban hospital. A 19-year-old male patient with a pacemaker implanted 10 days earlier suffered from delayed perforation of the right ventricle with cardiac tamponade. A review of the literature revealed that cardiac tamponade is a rare complication of pacemaker implantation. Pacemakers should only be implanted by physicians with relevant experience, and emergency room physicians should be aware of the possibility of the associated complications and be prepared to treat them.
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Comparative Study
Improving the pattern of work towards emergency medicine at the Emergency Department in Rambam Medical Centre.
Rambam Medical Centre is a 950-bed referral hospital, containing 34 beds in the Emergency Department (ED). The arrangement of the ED was based on two separate units: trauma and medical. Patient evaluation lasted many hours, with an abuse of consultants, laboratory and imaging services. ⋯ By changing work methods according to emergency medicine guidelines, and by using protocols written for emergency medicine, a significant improvement in our duties as an ED was achieved. The backing of the hospital management helped to implement the changes, which led to the functional improvement.
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To identify the occurrence of adverse events in stroke patients presenting to the emergency department of a tertiary university facility, and to disclose the categories of adverse events associated with death. ⋯ Adverse events, mostly severe, predominated among deceased patients, resulting mainly from diagnostic or therapeutic procedures and nursing activities. In spite of limitations concerning the observational retrospective nature of this study, we found that severe adverse events, medical adverse events, and nosocomial infections were significantly associated with death in stroke patients.