BMC emergency medicine
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BMC emergency medicine · Jun 2020
Prevalence of crowding, boarding and staffing levels in Swedish emergency departments - a National Cross Sectional Study.
Emergency Department (ED) crowding occurs when demand for care exceeds the available resources. Crowding has been associated with decreased quality of care and increased mortality, but the prevalence on a national level is unknown in most countries. ⋯ ED crowding based on occupancy rate was prevalent on a national level in Sweden and comparable with international data. Staff workload, boarding and patient to staff ratios were generally lower than previously described.
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BMC emergency medicine · Jun 2020
Observational StudyEvaluation of manual chest compressions according to the updated cardiopulmonary resuscitation guidelines and the impact of feedback devices in an educational resuscitation course.
The cardiopulmonary resuscitation guidelines revised in 2015 recommend target chest compression rate (CCR) and chest compression depth (CCD) of 100-120 compressions per minute (cpm) and 5-6 cm, respectively. We hypothesized that the new guidelines are harder to comply with, even with proper feedback. ⋯ Compliance with the new guidelines for chest compressions, especially those regarding the CCD, might be difficult. However, whether the changes in guidelines affect outcomes in actual clinical settings is uncertain and requires further investigation.
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BMC emergency medicine · Jun 2020
Piloting data linkage in a prospective cohort study of a GP referral scheme to avoid unnecessary emergency department conveyance.
UK Ambulance services are under pressure to safely stream appropriate patients away from the Emergency Department (ED). Even so, there has been little evaluation of patient outcomes. We investigated differences between patients who are conveyed directly to ED after calling 999 and those referred by an ambulance crew to a novel GP referral scheme. ⋯ Despite limited data and a small sample size, there were differences between patients conveyed directly to ED and those who were referred into GP care. Initial evidence suggests that referring individuals to a GP may provide an appropriate and safe alternative path of care. This pilot study demonstrated a need for larger scale, methodologically rigorous study to demonstrate the benefits of alternative conveyance schemes and recommend changes to the current system of urgent and emergency care.
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BMC emergency medicine · Jun 2020
Observational StudyThe growing impact of older patients in the emergency department: a 5-year retrospective analysis in Brazil.
The average age of the global population is rising at an increasing rate. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance. ⋯ In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification.