Emergency medicine journal : EMJ
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Multicenter Study
Derivation and validation of a sensitive IMA cutpoint to predict cardiac events in patients with chest pain.
In patients with acute chest pain, we derived a cutpoint for ischaemia-modified albumin (IMA) and prospectively validated this cutpoint to predict 30-day major adverse cardiac events (MACEs). ⋯ We prospectively validated the sensitive IMA cutpoint of 75 KU/litre with 80% sensitivity for MACEs in patients with acute chest pain. Our data suggest that IMA alone and in combination with initial hsTnT are more sensitive than the initial hsTnT for MACEs.
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Multicenter Study Comparative Study
An evaluation of an educational intervention to reduce inappropriate cannulation and improve cannulation technique by paramedics.
Intravenous cannulation enables administration of fluids or drugs by paramedics in prehospital settings. Inappropriate use and poor technique carry risks for patients, including pain and infection. We aimed to investigate the effect of an educational intervention designed to reduce the rate of inappropriate cannulation and to improve cannulation technique. ⋯ The educational intervention was effective in bringing about changes leading to enhanced quality and safety in some aspects of prehospital cannulation.
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The aim of this study is to map and evaluate the available resources and the premises of traumatic head injury management in the Nordic countries, before the implementation of a Nordic adaption of the Brain Trauma Foundation guidelines for prehospital management. ⋯ Most Nordic hospitals are well prepared to manage patients with acute traumatic head injury. A substantial proportion of the operations are performed at local and central hospitals without neurosurgical expertise, despite an efficient pre and interhospital transport system. The Nordic adaption of the Brain Trauma Foundation guidelines recommends that this practice is terminated.
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Multicenter Study
The relationship between body temperature, heart rate and respiratory rate in children.
To describe and quantify the effect that increasing body temperature has on heart rate and respiratory rate in children attending a paediatric emergency department (ED). ⋯ Body temperature is an independent determinant of heart rate, causing an increase of approximately 10 beats per minute per degree centigrade. Body temperature is also an independent determinant of respiratory rate. This quantification may help in the assessment of the hot and unwell child, to determine whether any tachycardia or tachypnoea is caused solely by fever, or whether there may be an element of concurrent shock.
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Multicenter Study
A national survey of clinical practice for the management of whiplash-associated disorders in UK emergency departments.
To undertake a national survey to determine current practice for the management of whiplash injuries in UK emergency departments (ED). ⋯ Verbal advice is the primary method for managing whiplash injuries in ED and is usually supplemented by written advice. Within individual hospitals there is a lack of consistency between verbal and written advice. The promotion of personal injury claims is a common feature of written advice. Research is required to develop effective and consistent models of advice.