European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We conducted a 25-week study of the emergency department's (ED) walk-in patients at a university hospital, covering 20% of the total period by a Latin square method of 6-h blocks. One thousand eight hundred walk-in patients entered the study group. The walk-in population represents approximately 44% of the total ED population. ⋯ About 10% of the walk-in patients were classified as 'symptoms, signs and ill-defined conditions' according to the International Classification of Diseases 9. Fifty-two per cent of these patients were discharged home. This group of patients requires further investigation.
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Neisseria meningitidis, a ubiquitous Gram-negative diplococcus, is responsible for a spectrum of clinical manifestations. This is illustrated by the history of three patients recently admitted to our hospital. Because of the possibly rapid and dramatic evolution, awareness for meningococcal diseases remains obligatory. Adequate antibiotic treatment instituted as soon as the diagnosis is suspected and early application of aggressive supportive care can lead to more favourable outcome.
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The aim of this survey was to explore treatment routines with regard to early heart attack care at various hospitals in Sweden. All the hospitals in Sweden with a coronary care unit or its equivalent were sent a postal enquiry about early heart attack care including use of various medications and educational level of health care providers. In all, 84 of 86 hospitals (98%) answered the enquiry. ⋯ This survey indicates that the vast majority of hospitals in Sweden use thrombolytic agents in more than 30% of AMI patients and aspirin in more than 80% of AMI patients. The use of intravenous beta-blockade is lower than expected. Considering the strong association between the delay before instituting therapy and outcome, it is surprising that treatment is not initiated more frequently outside hospital or in the emergency department.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of the efficacy of lysine acetylsalicylate, indomethacin and pethidine in acute renal colic.
The aim of this study was to compare the analgesic efficacy of intravenous lysine acetylsalicylate 1.8 g, indomethacin 100 mg and pethidine 100 mg in acute renal colic in a randomized double-blind clinical trial. One hundred and fifty patients with acute renal colic were divided into three groups. The first group received lysine acetylsalicylate 1.8 g, the second group received indomethacin 100 mg and the third group received pethidine 100 mg. ⋯ Lysine acetylsalicylate was less effective than indomethacin and pethidine. It is concluded that intravenous indomethacin is an effective alternative to intravenous pethidine in the treatment of acute renal colic. Intravenous lysine acetylsalicylate is inferior to intravenous indomethacin in treatment of acute renal colic.
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Modern emergency medicine requires the use of temporary observation (TO) to direct diagnostic and therapeutic decisions. The position of TO in the hospital structure has been well defined in the legal sense, inasmuch as it provides the preparatory stage for the final specialized medical treatment the patient will receive after admission. TO has become indispensable in emergency medicine to provide prompt treatment of critically ill patients and to clarify as rapidly as possible uncertain cases to avoid unnecessary admissions and transfers. To operate effectively, the service of TO must be provided well-trained staff, suitable physical facilities and support services, and access to rapid specialty consultations within the emergency room environment.