BMC emergency medicine
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BMC emergency medicine · Jan 2012
Duration of patients' visits to the hospital emergency department.
Length of stay is an important indicator of quality of care in Emergency Departments (ED). This study explores the duration of patients' visits to the ED for which they are treated and released (T&R). ⋯ The duration of T&R ED visits varied significantly by admission hour, day of the week, patient volume, patient characteristics, hospital characteristics and area characteristics.
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BMC emergency medicine · Jan 2012
Case ReportsIdentical fracture patterns in combat vehicle blast injuries due to improvised explosive devices; a case series.
In November 2008, a surgical team from the Red Cross Hospital Beverwijk, the Netherlands, was deployed in Afghanistan for three months to attend in the army hospital of Kandahar.During their stay, four incidents of armored personnel carriers encountering an improvised explosive device were assessed. In each incident, two soldiers were involved, whose injuries were strikingly similar. ⋯ From this case series, as well as the existing literature on injury patterns caused by blast injuries, it seems appropriate to pay extra attention to bodily areas that were injured in other occupants of the same vehicle. Obviously, the additional surveillance for specific injuries should be complementary to the regular trauma work-up (e.g., ATLS).
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BMC emergency medicine · Jan 2012
The critical incident inventory: characteristics of incidents which affect emergency medical technicians and paramedics.
Emergency medical technicians (EMTs) and paramedics experience critical incidents which evoke distress and impaired functioning but it is unknown which aspects of incidents contribute to their impact. We sought to determine these specific characteristics by developing an inventory of critical incident characteristics and testing their relationship to protracted recovery from acute stress, and subsequent emotional symptoms. ⋯ Emotional sequelae are associated most strongly with EMT/paramedics' personal experience, and least with systemic characteristics. A14-item inventory identifies critical incident characteristics associated with emotional sequelae. This may be helpful in tailoring recovery support to individual provider needs.
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BMC emergency medicine · Jan 2012
Depression is associated with longer emergency department length of stay in acute coronary syndrome patients.
Patient demographic characteristics have been associated with longer emergency department (ED) treatment times, but the influence of psychosocial characteristics has not been assessed. We evaluated whether depression was associated with greater ED length of stay (LOS) in non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA) patients presenting to a large metropolitan academic medical center. ⋯ Currently depressed NSTEMI/UA patients are in the ED for an average of 5 hours longer than those who have never been depressed. Further research is needed to identify the reasons for this difference.
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BMC emergency medicine · Jan 2012
Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa.
Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 to 44 years. Uncontrolled hemorrhage and coagulopathy is responsible for over 50% of all trauma related deaths within the first 48 hrs of admission. Coagulation profiles are not routinely done among trauma patients in resource limited settings and there is a paucity of data on acute traumatic coagulopathy (ATC) in sub Saharan Africa. The study was conducted to evaluate the prothrombin time and partial thromboplastin time (PT/PTT) as predictors of mortality and morbidity among major trauma patients. ⋯ A significant proportion of major trauma patients were coagulopathic. Initial coagulation profile is useful in predicting outcomes for major trauma patients.