Emergency medicine journal : EMJ
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In the Netherlands, screening for child maltreatment is mandatory in all emergency departments but it is unclear which screening methods are being used. As a first step towards implementation of a universal screening method across all emergency departments, we assessed the currently used screening methods. ⋯ Large variations in screening methods exist across emergency departments in the Netherlands, most of which are not based on empirical evidence.
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Biomarkers have been developed in emergency medicine to improve decision at bedside using Bayesian approach. We intend to determine the cognitive process actually utilised by emergency physicians to incorporate biomarkers in clinical reasoning. ⋯ Although biomarkers have been developed to be used in a Bayesian approach, emergency physicians mainly use other analytical and non-analytical cognitive processes to introduce these tools in their clinical reasoning.
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By contrast with neurologic injury, myocardial injury associated with carbon monoxide (CO) poisoning has not been well investigated. Therefore, this study assessed features and predictors of myocardial injury in CO poisoned patients. ⋯ Myocardial injury developed in 20% of CO poisoned patients. Time to normalisation and of peak Tn I level in elevated Tn I group was 65.0 (IQR 44.0-96.0) h and 11.0 (IQR 4.5-18.5) h. Presence of myocardial injury was associated with poorer prognosis. Predictors of myocardial injury included male gender, GCS of 14 or less, or CO exposure times greater than 2 h.
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To determine the association between the American Society of Anesthiologists (ASA) grade and the complication rate of patients receiving procedural sedation for relocation of hip prosthesis in an adult emergency department (ED) in the UK. ⋯ There is no clear association between a patient's physical status (ASA grade) and the risk of complications, chance of procedural success or choice of sedative agent in relocation of hip prostheses. There is a higher rate of complications with higher levels of sedation (p<0.001).
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To improve the detection and quality of care of patients who attend the emergency department (ED) with confirmed or suspected domestic abuse (DA). ⋯ Strong leadership and prioritising the issue within the department has facilitated the development of the process and contributed substantially to its success. Support from community partners has been invaluable in tailoring the service and education programme to the needs of staff and patients within the department.