Emergency medicine journal : EMJ
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The Paediatric Triage Tape (PTT) is an easy to use major incident primary triage tool, based upon a modification of the Triage Sieve. The purpose of this study was to prospectively validate the PTT for use in paediatric major incidents. ⋯ The PTT has poor sensitivity at identifying immediate priority children by these criteria. Specificity (the ability to identify non-T1 patients) is excellent, and the overtriage and undertriage rates are within the range deemed unavoidable by the American College of Surgeons.
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There is a trend towards accelerated management of acute atrial fibrillation (AF) in the emergency department (ED). We report our experience with biphasic cardioversion of acute AF. ⋯ Biphasic cardioversion of acute AF is effective. The majority of patients can be managed as outpatients, and there is very high patient satisfaction with this approach. An initial shock energy level of 100 J is usually effective.
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To compare injury patterns in children with many and few emergency department (ED) visits in order to reveal the causes for the frequent visits. ⋯ Children with many ED visits had less severe injuries and more dislocations, sprains, and strains.
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To quantify the health gains and costs associated with improving ambulance and thrombolysis response times for acute myocardial infarction. ⋯ Improving ambulance response times appears to be cost effective. Reducing door-to-needle time will have a smaller effect at an uncertain cost. Further benefits may be gained from reducing the time from onset of symptoms to starting thrombolysis.
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Rapid streptococcal tests (RSTs) for streptococcal pharyngitis have made diagnosis at once simpler and more complicated. The American Academy of Pediatrics recommends that all RSTs be confirmed by a follow up throat culture unless local validation has proved the RST to be equally sensitive. ⋯ The high specificity of RST facilitates early diagnosis of strep throat. However, the low sensitivity of RST does not support its use as a single diagnostic tool. The sensitivity in the present study is markedly different from that reported by the manufacturer. Clinical examination is of limited value in the diagnosis of strep throat. It is important to audit the performance of new diagnostic tests, previously validated in different settings.