Emergency medicine journal : EMJ
-
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.
-
Randomized Controlled Trial
Efficacy of metronome sound guidance via a phone speaker during dispatcher-assisted compression-only cardiopulmonary resuscitation by an untrained layperson: a randomised controlled simulation study using a manikin.
Untrained laypersons should perform compression-only cardiopulmonary resuscitation (COCPR) under a dispatcher's guidance, but the quality of the chest compressions may be suboptimal. We hypothesised that providing metronome sounds via a phone speaker may improve the quality of chest compressions during dispatcher-assisted COCPR (DA-COCPR). ⋯ Metronome sound guidance during DA-COCPR for the untrained bystanders improved the chest compression rates, but was associated more with shallow compressions than the conventional DA-COCPR in a manikin model.
-
Early management improves outcome in acute stroke. This study was designed to assess the prehospital path from symptom onset to arrival in hospital and to identify factors associated with prehospital delay. ⋯ Severe strokes, use of ambulance and lower age are associated with reduced prehospital delay. The present study shows that more than half of the delay is caused by the hesitation to contact medical services. Public information campaigns should focus on fast symptom recognition and the importance of immediately contacting the Emergency Medical Services upon symptom onset.
-
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.
-
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.