Emergency medicine journal : EMJ
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Observational Study
The Royal College of Emergency Medicine composite pain scale for children: level of inter-rater agreement.
To assess the inter-rater agreement of the Royal College of Emergency Medicine (RCEM) Composite Pain Scale. ⋯ The Ladder score could be omitted from this composite tool as it has poor inter-rater agreement in comparison with the other indicators.
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The original Manchester Acute Coronary Syndromes model (MACS) 'rules in' and 'rules out' acute coronary syndromes (ACS) using high sensitivity cardiac troponin T (hs-cTnT) and heart-type fatty acid binding protein (H-FABP) measured at admission. The latter is not always available. We aimed to refine and validate MACS as Troponin-only Manchester Acute Coronary Syndromes (T-MACS), cutting down the biomarkers to just hs-cTnT. ⋯ T-MACS could 'rule out' ACS in 40% of patients, while 'ruling in' 5% at highest risk using a single hs-cTnT measurement on arrival. As a clinical decision aid, T-MACS could therefore help to conserve healthcare resources.
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The aim of this study was to explore the potential of ambulance call-out data in understanding violence to inform about prevention activity. ⋯ Ambulance call-out data can provide a wealth of information to understand violence and subsequently inform about violence prevention and response activity. Ambulance services and staff could play a key role in preventing violence through sharing data and identifying and supporting victims.
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Drowning is a high-priority public health problem around the world. The European Resuscitation Council Guidelines for Resuscitation 2015 put special emphasis on special environments like open waters. Stopping the drowning process as soon as possible and starting an early cardiopulmonary resuscitation (CPR) improve survival. Inflatable rescue boats (IRBs) are used around the world in the water rescue of drowning victims. Our objective was to test the quality of CPR performed by surf-lifeguards while sailing on an IRB. ⋯ Surf-lifeguards are able to deliver good-quality CPR even on a moving IRB, but their performance is lower than onshore. This fact should be considered in real cases to balance the risk and benefits of CPR on board.