European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of this study was to evaluate short- and long-term outcome prior to and after the introduction of a more intensified treatment in the ambulance of patients with acute severe heart failure. Consecutive patients with acute severe heart failure transported by the mobile coronary care unit (MCCU) in the community of Göteborg prior to and after the introduction of an intensified treatment (nitroglycerine, continuous positive airway pressure (CPAP) and furosemide). One hundred and fifty-eight patients were evaluated during each period. ⋯ However, the mortality during the first year remained high during both periods (39.2% and 35.8%, p = 0.64). It is concluded that a more intensive treatment in the ambulance of patients with acute severe heart failure seems to have resulted in an improvement in symptoms during transport and less myocardial damage. However, no significant improvement in long-term mortality was observed.
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The teaching of cardiopulmonary resuscitation (CPR) has had a positive public health impact beyond resuscitating cardiac arrest victims to include recognition of signs and symptoms and prevention of heart attacks. To study the general knowledge and degree of preparedness in the Republic of Poland, a national survey was conducted. ⋯ The results indicate that (1) approximately 75% of the Polish population has received CPR training; (2) the majority of the surveyed population assess their CPR ability as inadequate; (3) the surveyed population believe that CPR training needs to be expanded and improved. Taking into consideration results of the CPR knowledge assessment questions it can be concluded that CPR knowledge in Poland is low and a standardized curriculum for CPR training is needed.
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Over the past decade, the philosophy of total quality has appeared in all fields of industry in Japan and the USA. This philosophy is now present all over Europe as well, Italy included. ⋯ The present article describes the main steps which led to an external accredited team granting the emergency department of this hospital a quality system certificate in 1997 according to the international quality system requirements UNI EN ISO 9002. The importance of this work lies in the fact than an industrial quality standardization system, whose requirements have little in common with a traditional view of medical practice, can nevertheless be applied to a public health care department.
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The aim of this study was to identify the risk profile of the victims of violent accidents. During 1997, we studied 1100 patients suffering from injuries produced by violent actions and treated in the emergency department of the largest teaching hospital in the Canary Islands, Spain. Seventy per cent of the patients were male and 30% were female. ⋯ None of the victims died as a result of violence. The admission of victims occurred predominantly during the night hours and 35% of the patients were treated during the weekend. It is concluded that the typical victim of violent accidents in an emergency department of a Spanish teaching hospital is a young male with severe injuries, which occurred during late hours at weekends.