European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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One of most stressful situations for a physician occurs when a patient is unable to breathe and endotracheal intubation is not possible. The establishment of an open airway by surgery is indicated only if the physician is unable to do so with an endotracheal tube. ⋯ We describe six patients, including two trauma patients, in whom emergency percutaneous tracheostomy was rapidly and successfully performed under conditions of the imminent loss of airway and inability to intubate the patient. As this procedure is safe and can be performed easily by experienced personnel, we propose its addition to the armamentarium of emergency airway management.
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Emergency services personnel, family members, laypersons or patients often carry and use mobile phones on sites of emergencies. As there are reported effects on implanted pacemakers and cardioverter defibrillators, the influence of digital cellular phones on automated external defibrillators was studied. ⋯ Shock advisory systems of automated external defibrillators are not susceptible to electromagnetic interference of 900 MHz cellular phones. Voice prompts, however, could be distorted by the operation of nearby digital mobile phones. During automated external defibrillator training this issue needs to be addressed.
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Fifty years after the London smog incident, the Milan area (Italy) is still experiencing an air pollution emergency every winter, widely reported in the public media, complete with technical and political discussion, and well-studied short-term associations between air pollution and mortality and hospital admissions. The influence of air pollution on the daily activity of an Accident and Emergency Department have rarely been investigated, other than looking at hospital admissions. ⋯ Air pollution, although still frequently high and relevant to the health of the population, is not easily recognizable on a small scale, such as a single hospital, and does not affect daily Accident and Emergency activities.
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An increasing and serious heroin overdose problem in Oslo has mandated the increasing out-of-hospital use of naloxone administered by paramedics. The aim of this study was to determine the frequencies and characteristics of adverse events related to this out-of-hospital administration by paramedics. ⋯ Although adverse events were common among patients treated for opioid overdose in an out-of-hospital setting, serious complications were rare. Out-of-hospital naloxone treatment by paramedics seems to save several lives a year without a high risk of serious complications.