Emergency medicine journal : EMJ
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To evaluate the effectiveness of a rapid assessment zone (RAZ) to mitigate emergency department (ED) overcrowding. ⋯ Although the results are consistent, and low acuity patients seem to benefit the most from a RAZ, the available evidence to support its implementation is limited.
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A short-cut review was carried out to establish the sensitivity and specificity of CRP as a tool for diagnosing bacteraemia. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line suggests that CRP is not a useful tool in the initial diagnosis of severe bacterial infection.
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Randomized Controlled Trial
Early out-of-hospital non-invasive ventilation is superior to standard medical treatment in patients with acute respiratory failure: a pilot study.
To assess in patients with acute respiratory failure (ARF) whether out-of-hospital (OOH) non-invasive ventilation (NIV) is feasible, safe and more effective compared with standard medical therapy (SMT). ⋯ OOH NIV proved to be feasible, safe and more effective for the treatment of ARF compared with SMT. OOH NIV promotes inhospital treatment with NIV and may reduce the frequency and length of ICU stays. Because the risks of OOH emergency intubation can be avoided, NIV should be the first-line treatment in OOH ARF if no contraindications are present.
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Emergency management is a relatively new research field in China. The severe acute respiratory syndrome epidemic in 2003 caused research and papers on emergency management to increase by leaps and bounds. This review summarises the progress of hospital emergency management research in China, highlights trends and challenges, and discusses likely solutions for research improvement. ⋯ Based on this study we suggest that hospital emergency management research in China should make efforts to (1) establish a universally accepted theory framework and terminology, (2) create a structure for further studies, (3) integrate research of different disciplines, and (4) avoid or minimise confusion. More attention should be paid on the evolvement mechanism of main public health incidents and disasters, and the key functional systems related to hospital's emergency response resiliencies. Focus should also be placed on practical guidelines and tools.
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A short-cut review was carried out to establish whether abdominal pain on hopping/jumping can assist in the initial diagnosis of appendicitis in children. Four studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the presence of abdominal pain when asked to hop seems to be both reasonably sensitive and specific to a diagnosis of appendicitis in children.