European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
We report a rare case of acute calcifying tendinitis resulting in acute carpal tunnel syndrome. Acute medical staff should be aware of this condition and the importance of early referral to avoid long term median nerve neuropathy.
-
Patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) commonly present to the emergency department for treatment. Some of them, despite appropriate therapy become more dyspnoeic with increasing acute respiratory failure. The requirement for intubation and mechanical ventilation is for these patients often associated with a prolonged and complicated intensive care unit stay and has been associated with morbidity and mortality rates in excess. ⋯ There are few published data on the question whether NIV could or should be started earlier and initiated in the emergency department. It seems that NIV treatment could be an effective addition to standard treatment especially for acute exacerbation of COPD. A more extensive and routine use of non-invasive ventilation in the emergency department requires further study.
-
Comparative Study
Systematic triage in the emergency department using the Australian National Triage Scale: a pilot project.
The objective of this study was to evaluate the validity in Belgium of the National Triage Scale for judgement of the urgency of a patient's condition and making a case-mix description of the patient profiles in the different urgency categories. The study is of a descriptive retrospective and descriptive correlational design and was carried out in the emergency department at the University Hospital Gasthuisberg in Leuven, Belgium. The urgency of patients arriving at the emergency department was evaluated during one randomly selected shift a day over 12 weeks in 1997 by one of the four triage-educated nurses, using an instrument based on the National Triage Scale. ⋯ Higher categories of urgency resulted in a higher degree of admission (t (df = 3640) = 643.45; p = 0.000). It is concluded that a resemblance between the pilot study and the reference confirms the predictive validity of the scale used. Patient profiles in the different urgency categories give a description of the emergency department population.
-
Randomized Controlled Trial Clinical Trial
Intravenous magnesium is ineffective in adult asthma, a randomized trial.
Intravenous magnesium sulphate (MgSO4) has been tried in the emergency department treatment of asthma since the mid-1980s, but published reports vary as to its efficacy. The literature suggests that it may be effective in the more severely ill asthmatic. We evaluated i.v. ⋯ In moderately severe adult asthmatics, 2.0 grams of MgSO4 i.v. resulted in less improvement in peak expiratory flow compared with placebo. MgSO4 did not appear to decrease subjective dyspnoea or the hospital admission rate. This evidence does not support the use of MgSO4 in the treatment of acute asthma.