Emergency medicine journal : EMJ
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Multicenter Study Comparative Study Observational Study
The comparison of modified early warning score with rapid emergency medicine score: a prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department.
There are a few scoring systems in emergency departments (ED) to establish critically ill patients quickly and properly and to predict hospitalisation. We aim to compare the efficacy of Modified Early Warning Score (MEWS) and Rapid Emergency Medicine Score (REMS) on in-hospital mortality, and as predictor of hospitalisation in general medical and surgical patients admitted to ED. ⋯ The efficiency of REMS was found to be superior to MEWS as a predictor of in-hospital mortality and hospitalisation in medical and surgical patients admitted to ED.
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This subjective review is based on a presentation made at the College of Emergency Medicine Scientific Conference in September 2013. My theme was that there are certain features of the critically ill which cause understandable anxiety, namely hypoxia, haemorrhage and hypotension. So, I have selected papers relevant to the management of these frightening situations.
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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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To explore the effect that different activities included in first aid training can have on an individual's propensity to act in a medical emergency. ⋯ Activities which allow the learner to explore and discuss behaviour in an emergency situation can effectively increase the learner's propensity to act. First aid education should be expanded to support the learner to develop both the skill and the will to help.
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Clinical trials are required to strengthen the evidence base for prehospital care. This questionnaire study aimed to explore paramedics' perceptions of prehospital research and barriers to conducting prehospital clinical trials. ⋯ Paramedics reported interest and understanding of research, but a number of practical and ethical barriers were recognised that need to be addressed if prehospital clinical trials are to increase.