Emergencias
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To analyze the diagnostic yield of a cut-point of 3 μg/mL for paracetamol in urine to screen for poisoning in children. ⋯ Measuring the paracetamol concentration in urine within 4 hours of dosing is useful to rule out prior intake of paracetamol and overdosing in PICU patients. Studies to validate the new cut-point of 3 μg/mL for paracetamol in urine are required with a view to possibly including it in a diagnostic protocol for suspected acute poisoning.
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To compare morbidity and mortality rates, the epidemiologic profile, and survival of patients with multiple injuries attended by the emergency services in the Navarre autonomous community in Spain in the periods of 2002-2003 and 2010-2012. ⋯ The problem of the number of young people injured in accidents in our community has been brought under control, but the proportion of older patients injured in falls has risen. This change may slow the effort to improve mortality rates in patients with multiple injuries and it obliges us to introduce measures to prevent falls in the elderly.
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The aim of this cross-sectional study was to analyze transport by helicopter emergency medical services (HEMS) in cases of ischemic cerebral stroke in Poland in 2011 and 2012. We assessed the role of the HEMS in reducing prehospital times and analyzed changes in patients' status during transport. ⋯ Helicopter transport of these patients is safe and ensures their transfer to the nearest hospital or ambulance within the treatment time window. Time spent on care at the scene of the emergency should probably be as short as possible.
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To determine whether the Identification of Seniors at Risk (ISAR) score predicts short-term adverse outcomes in elderly patients discharged from a short-stay unit. ⋯ An ISAR score of 3 or higher is able to identify elderly individuals at high risk of an adverse outcome within 30 days of discharge from a short-stay unit.
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To design and validate a clinical simulation method for training nurses to use the Emergency Severity Index (ESI) for triage. ⋯ This study supports the relevance of clinical simulations for training nurses to implement structured triage, and in particular to use the ESI. We can state that this study opens the door to further research into whether the reliability of triage can be improved by using this approach, specifically whether it can facilitate better interobserver agreement.