Emergency medicine journal : EMJ
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Telephone calls for emergency ambulances are rising annually, increasing the pressure on ambulance resources for clinical problems that could often be appropriately managed in primary care. ⋯ Many calls are based on fundamental misconceptions about the types of treatment other urgent-care avenues can provide, which may be amenable to educational intervention. This is particularly relevant for patients with chronic conditions with frequent exacerbations. Callers who have care responsibilities often default to the most immediate response available, with decision making driven by a lower tolerance of perceived risk. There may be a greater role for more detailed triage in these cases, and closer working between ambulance responses and urgent primary care, as a perceived or actual distance between these two service sectors may be influencing patient decision making on urgent care.
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A shortcut review was carried out to establish whether levosimendan improves outcome in septic shock. Eight studies were directly relevant to the question. ⋯ The clinical bottom line is that there is as yet no evidence that levosimendan reduces mortality from septic shock. The LeoPARDS trial may change that.
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Only a few cardiac-arrest victims receive external chest compression (ECC) by a bystander. ⋯ The better 'advantages over disadvantages' score for the automated ECC device over manual ECC indicated that the general public might envisage use of the device. This could contribute to increase the frequency of resuscitation attempts by bystanders.