Emergency medicine journal : EMJ
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Multicenter Study Comparative Study
The emerging role of the emergency care practitioner.
To examine the emerging role of the emergency care practitioner (ECP) with comparisons to paramedic practice. Key activities were identified of newly appointed ECPs using qualitative methodology and a qualitative and quantitative comparison of patient treatment was made. ⋯ The results indicate that an investment in the ECP role could be beneficial, however, more work is required to evaluate the development of practice, the quality of care, and cost benefits.
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Multicenter Study
Are we training junior doctors to respond to major incidents? A survey of doctors in the Wessex region.
To assess the current status of awareness and training of junior medical staff in the Wessex region in the event of a "conventional" major incident. ⋯ Most middle grade staff in Wessex were not confident of their role in the event of a major incident. Most SpRs questioned had never attended a major incident training exercise.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Witnessed arrest, but not delayed bystander cardiopulmonary resuscitation improves prehospital cardiac arrest survival.
This study correlated the effect of witnessing a cardiac arrest and instituting bystander CPR (ByCPR), as a secondary end point in a study evaluating the effect of bicarbonate on survival. ⋯ Survival after prehospital cardiac arrest is more likely when witnessed, but not necessarily when ByCPR was performed by laymen.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Prehospital cardiac arrest outcome is adversely associated with antiarrythmic agent use, but not associated with presenting complaint or medical history.
This study associated survival from prehospital cardiac arrest to patient historical variables including presenting complaint, medications used, and medical history as a secondary end point in a trial evaluating the effect of bicarbonate administration. This raises issues concerning extensive prehospital historical assessment that may potentially delay care and transport. ⋯ There is little relation of patient historical factors on the outcome from prehospital cardiac arrest raising issues of efficiency with history taking in prehospital care and transport.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Non-invasive ventilation in acute respiratory failure: a randomised comparison of continuous positive airway pressure and bi-level positive airway pressure.
To determine whether there is a difference in required duration of non-invasive ventilation between continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) in the treatment of a heterogeneous group of emergency department (ED) patients suffering acute respiratory failure and the subgroup of patients with acute pulmonary oedema (APO). Secondary objectives were to compare complications, failure rate, disposition, length of stay parameters, and mortality between the treatments. ⋯ These results suggest that there is no significant difference in the duration of non-invasive ventilation treatment between CPAP and BiPAP when used for the treatment of acute respiratory failure in the ED. There was also no significant difference between the groups in secondary end points.