Emergency medicine journal : EMJ
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A shortcut review was carried out to establish whether pin management or sedation is indicated to improve outcome in patients who show signs of awareness during cardiopulmonary resuscitation (CPR). Seven papers presented the best evidence to answer the clinical question. ⋯ Further research is needed before definite guidance can be given. Local advice should be followed.
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To present a systematic review on the reliability of triage systems for paediatric emergency care. ⋯ There is some evidence on the reliability of the PedCTAS, MTS and ESI V.4, but most studies are limited to the countries where they were developed. Efforts are needed to improve the quality of the studies, and cross-cultural adaptation of those tools is recommended in countries with different professional qualification and sociocultural contexts.
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Observational Study
Accuracy of nature of call screening tool in identifying patients requiring treatment for out of hospital cardiac arrest.
A new pre-triage screening tool, Nature of Call (NoC), has been introduced into the telephone triage system of UK ambulance services which employ National Health Service Pathways (NHSP). Its function is to provide rapid recognition of patients who may need immediate ambulance dispatch for out-of-hospital cardiac arrest (OHCA) and withholding dispatch for other calls while further triage is undertaken. In this study, we evaluated the accuracy of NoC and NHSP in identifying patients with potentially treatable or imminent OHCA. ⋯ NoC and NHSP call categorisation each achieved similar sensitivity for the identification of OHCATR, identifying most of the same patients, but each captured unique patients. Using both methods sequentially improved accuracy. The 16% of OHCATR patients not identified by either method present a challenge to ambulance dispatch systems.