Emergency medicine journal : EMJ
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Updated life-support guidelines were published by the European Resuscitation Council (ERC) in 2010, increasing the required depth and rate of chest compression delivery. This study sought to determine the impact of these guidelines on rescuer fatigue and cardiopulmonary resuscitation (CPR) performance. ⋯ Fatigue affects chest compression delivery within the second minute of CPR under the 2010 ERC guidelines, and is poorly judged by rescuers. Rescuers should, therefore, be encouraged to interchange after 2 min of CPR delivery. Team leaders should be advised to not rely on rescuers to self-report fatigue, and should, instead, monitor for its effects.
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Emergency department (ED) crowding impacts negatively on quality of care. The aim was to determine the association between ED quality and input, throughput and output-associated variables. ⋯ Throughput is the major determinant of EDQPI, notably time interval reflecting the work dynamics of medical and nursing teams and the efficacy of fast-track routes for low-complexity patients. Output also significantly impacted on EDQPI, particularly the capacity to reduce the LOS of admitted patients.
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This study was conducted to determine the proper hand position on the sternum for external chest compression to generate a maximal haemodynamic effect during cardiopulmonary resuscitation (CPR). ⋯ Only a small proportion of the ventricle is subjected to external chest compression when CPR is performed according to the current guidelines. Compression of the sternum at the sternoxiphoid junction might be more effective to compress the ventricles.
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A short-cut review was carried out to establish whether measurement of the plasma calprotectin (S100A8/A9) level can be used to enable safe exclusion of acute appendicitis in children presenting to the emergency department with abdominal pain. Four studies were directly relevant to the question. ⋯ The clinical bottom line is that there is currently no evidence to suggest that serum calprotectin is superior to standard inflammatory markers for the exclusion or confirmation of suspected appendicitis. Clinical examination findings remain the cornerstone of surgical decision-making.
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New Zealand is hosting the Rugby World Cup (RWC) 2011. It is the largest sporting event in New Zealand's history, with around 70,000 fans estimated to visit the country from September to October 2011. This influx of tourists will have an impact on its already stretched healthcare services. The preparedness of New Zealand's healthcare system to handle this mass event is unclear. ⋯ Only 12.7% of acute care providers in New Zealand perceived preparedness for RWC 2011. Perceived preparedness followed a stepwise decline from prehospital services, emergency department, to surgery and then finally to intensive care services. This indicates that current preparedness activities are focusing on prehospital emergency services and neglecting surgical and intensive care services. Awareness about the role of acute care providers during emergencies, training and previous experience were associated with perceived strong preparedness for RWC 2011.