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    343 results match your criteria BMC Emergency Medicine[Journal]

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    The association of duration of boarding in the emergency room and the outcome of patients admitted to the intensive care unit.
    BMC Emerg Med 2017 Nov 9;17(1):34. Epub 2017 Nov 9.
    Intensive Care Department, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
    Background: The demand for critical care beds is increasing out of proportion to bed availability. As a result, some critically ill patients are kept in the Emergency Department (ED boarding) awaiting bed availability. The aim of our study is to examine the impact of boarding in the ED on the outcome of patients admitted to the Intensive Care Unit(ICU). Read More

    Cardiac patients' perceptions of neighboring patients' risk: influence on psychological stress in the ED and subsequent posttraumatic stress.
    BMC Emerg Med 2017 Nov 6;17(1):33. Epub 2017 Nov 6.
    Center for Behavioral Cardiovascular Health, Columbia University Medical Center, 622 W. 168th St, PH9-317, New York, NY, 10032, USA.
    Background: As many as 12% of acute coronary syndrome (ACS) patients screen positive for post-traumatic stress disorder (PTSD) symptoms due to their cardiac event, and emergency department (ED) factors such as overcrowding have been associated with risk for PTSD. We tested the association of patients' perceptions of their proximity to a critically ill patient during ED evaluation for ACS with development of posttraumatic stress symptoms (PSS) in the month after hospital discharge.

    Methods: Participants were enrolled in the REactions to Acute Care and Hospitalization (REACH) study during evaluation for ACS in an urban ED. Read More

    Who breaches the four-hour emergency department wait time target? A retrospective analysis of 374,000 emergency department attendances between 2008 and 2013 at a type 1 emergency department in England.
    BMC Emerg Med 2017 Nov 2;17(1):32. Epub 2017 Nov 2.
    Centre on Population Approaches for Non-Communicable Disease Prevention, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
    Background: The four-hour target is a key hospital emergency department performance indicator in England and one that drives the physical and organisational design of the ED. Some studies have identified time of presentation as a key factor affecting waiting times. Few studies have investigated other determinants of breaching the four-hour target. Read More

    Locating helicopter emergency medical service bases to optimise population coverage versus average response time.
    BMC Emerg Med 2017 Oct 16;17(1):31. Epub 2017 Oct 16.
    Rotterdam School of Management, Rotterdam, The Netherlands.
    Background: New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along the eastern seaboard. The aim of this study was to estimate optimal HEMS base locations within NSW using advanced mathematical modelling techniques.

    Methods: We used high resolution census population data for NSW from 2011 which divides the state into areas containing 200-800 people. Read More

    Trauma burden in Tanzania: a one-day survey of all district and regional public hospitals.
    BMC Emerg Med 2017 Oct 13;17(1):30. Epub 2017 Oct 13.
    Department of Emergency Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
    Background: Trauma contributes significantly to the burden of disease and mortality throughout the world, but particularly in developing countries. In Tanzania, there is an enormous research gap on trauma; the limited data available reflects realities in cities and areas with moderately- to highly-resourced treatment centers. Our aim was to provide a description of the injury epidemiology across all of Tanzania. Read More

    Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study.
    BMC Emerg Med 2017 Oct 3;17(1):29. Epub 2017 Oct 3.
    Tehran University of Medical Sciences-International Campus, Tehran, Iran.
    Background: Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities and trauma caused by the road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the pre-hospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA). Read More

    Identifying priorities for quality improvement at an emergency Department in Ghana.
    BMC Emerg Med 2017 Aug 30;17(1):28. Epub 2017 Aug 30.
    Department of Emergency Medicine, Korle Bu Teaching Hospital, Accra, Ghana.
    Background: Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program. Read More

    Recognition and treatment of severe sepsis in the emergency department: retrospective study in two French teaching hospitals.
    BMC Emerg Med 2017 Aug 30;17(1):27. Epub 2017 Aug 30.
    Service des urgences, CHU de Nantes, 44035, Nantes cedex 01, France.
    Background: Sepsis management in the Emergency Department remains a daily challenge. The Surviving Sepsis Campaign (SSC) has released three-hour bundle. The implementation of these bundles in European Emergency Departments remains poorly described. Read More

    Design and rationale of the Procalcitonin Antibiotic Consensus Trial (ProACT), a multicenter randomized trial of procalcitonin antibiotic guidance in lower respiratory tract infection.
    BMC Emerg Med 2017 Aug 29;17(1):25. Epub 2017 Aug 29.
    Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
    Background: Overuse of antibiotics is a major public health problem, contributing to growing antibiotic resistance. Procalcitonin has been reported to be commonly elevated in bacterial, but not viral infection. Multiple European trials found procalcitonin-guided care reduced antibiotic use in lower respiratory tract infection, with no apparent harm. Read More

    Post-traumatic stress disorder and its predictors in emergency medical service personnel: a cross-sectional study from Karachi, Pakistan.
    BMC Emerg Med 2017 Aug 29;17(1):26. Epub 2017 Aug 29.
    Community Health Sciences Department, Aga Khan University, Karachi, Pakistan.
    Background: Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible to developing stress-reactions. This study assesses symptoms of post-traumatic stress disorder and its predictors among the personnel of a selected EMS in Karachi, Pakistan.

    Methods: Data were gathered from 518 personnel working in an EMS setting from February to May 2014. Read More

    Emergency medical service provider decision-making in out of hospital cardiac arrest: an exploratory study.
    BMC Emerg Med 2017 Jul 25;17(1):24. Epub 2017 Jul 25.
    University of the West of England, Bristol, UK.
    Background: There are approximately 60,000 out-of-hospital cardiac arrests (OHCA) in the United Kingdom (UK) each year. Within the UK there are well-established clinical practice guidelines that define when resuscitation should be commenced in OHCA, and when resuscitation should cease. Background literature indicates that decision-making in the commencement and cessation of resuscitation efforts in OHCA is complex, and not comprehensively understood. Read More

    Misuse of emergent healthcare in contemporary Japan.
    BMC Emerg Med 2017 Jul 14;17(1):23. Epub 2017 Jul 14.
    Department of Medical Ethics, Tohoku University Graduate School of Medicine, 2-1 Aoba-Ku Seiryomachi, Sendai, 9808575, Japan.
    Background: Medical care is obviously an important public service to ensure the health of a nation; however, medical resources are not always used appropriately. 'Convenience-store consultations' and inappropriate ambulance transportation represent instances of such improper use by contemporary Japanese citizens in recent years. This article illustrates two examples of misuse and discusses potential countermeasures by considering factors contributing to these behaviours. Read More

    Hypoxia and hypotension in patients intubated by physician staffed helicopter emergency medical services - a prospective observational multi-centre study.
    BMC Emerg Med 2017 Jul 11;17(1):22. Epub 2017 Jul 11.
    Norwegian Air Ambulance Foundation, Drøbak, Norway.
    Background: The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important quality indicators of care provided by emergency medical services. Excluding cardiac arrests, critical trauma and non-trauma patients remain the two major groups to which helicopter emergency medical services (HEMS) are dispatched. Read More

    Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.
    BMC Emerg Med 2017 Jun 27;17(1):21. Epub 2017 Jun 27.
    Department of Medical Laboratory Sciences, Hawassa University, College of Medicine and Health Sciences, Hawasa, Ethiopia.
    Background: Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Read More

    Reasons for encounter by different levels of urgency in out-of-hours emergency primary health care in Norway: a cross sectional study.
    BMC Emerg Med 2017 Jun 24;17(1):19. Epub 2017 Jun 24.
    National Centre for Emergency Primary Health Care, Uni Research Health, Kalfarveien 31, 5018, Bergen, Norway.
    Background: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels.

    Methods: We analyzed data on RFEs in Norwegian OOH services. Read More

    Development of an education campaign to reduce delays in pre-hospital response to stroke.
    BMC Emerg Med 2017 Jun 24;17(1):20. Epub 2017 Jun 24.
    Clinical Geriatrics Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy.
    Background: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness.

    Methods: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development. Read More

    Educational standards for training paramedics in ultrasound: a scoping review.
    BMC Emerg Med 2017 Jun 17;17(1):18. Epub 2017 Jun 17.
    Department of Community Emergency Health and Paramedic Practice, Monash University - Peninsula Campus, PO Box 527, McMahons Road, Frankston, VIC, 3199, Australia.
    Background: Paramedic-performed out-of-hospital ultrasound is a novel skill that has gained popularity in some services in recent years. In this setting point-of care ultrasound (POCUS) can provide additional information that can assist with management and guide transport to the most appropriate facility. We sought to explore the different educational approaches used for training paramedics in ultrasound in the out-of-hospital setting. Read More

    Incidence and outcome of severe ante-partum hemorrhage at the Teaching Hospital Yalgado Ouédraogo in Burkina Faso.
    BMC Emerg Med 2017 May 31;17(1):17. Epub 2017 May 31.
    Yalgado Ouédraogo Hospital, Ouagadougou, Burkina Faso.
    Background: Hemorrhage is the main cause of maternal death during pregnancy. This study aims to evaluate incidence and outcomes of Severe Ante Partum Hemorrhage (SAPH) during the third trimester of pregnancy prior to delivery.

    Methods: Analytical cross-sectional study with prospective data collection during 12 months in Yalgado Ouedraogo Hospital, Ouagadougou, Burkina Faso. Read More

    Emergency department use and barriers to wellness: a survey of emergency department frequent users.
    BMC Emerg Med 2017 May 10;17(1):16. Epub 2017 May 10.
    Department of Emergency Medicine, Summa Health System, 525 E. Market Street, Akron, OH, 44304, USA.
    Background: There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED frequent users present to the ED, what barriers to care exist, and what service offerings may help these patients achieve an optimal level of health were conducted. Read More

    Management of potentially life-threatening emergencies at 74 primary level hospitals in Mongolia: results of a prospective, observational multicenter study.
    BMC Emerg Med 2017 May 8;17(1):15. Epub 2017 May 8.
    Department of Critical Care, University College of London Hospital, London, NW1 2BU, UK.
    Background: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals.

    Methods: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Read More

    Developing quality indicators for the care of patients with musculoskeletal injuries in the Emergency Department: study protocol.
    BMC Emerg Med 2017 May 5;17(1):14. Epub 2017 May 5.
    Centre for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
    Background: Musculoskeletal injuries are a common presentation to the Emergency Department (ED). The quality of care provided is important to the patients, clinicians, organisations and purchasers of care. In the context of the increasing burden of musculoskeletal disease, quality of care needs to occur despite financial impacts, variations in care, and pressure to reach time-based performance measures. Read More

    Estimation of the severity of breathlessness in the emergency department: a dyspnea score.
    BMC Emerg Med 2017 Apr 26;17(1):13. Epub 2017 Apr 26.
    Department of Hydrodynamic Systems, Budapest University of Technology and Economics, Budapest, Hungary.
    Background: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. Read More

    The association of Emergency Department presentations in pregnancy with hospital admissions for postnatal depression (PND): a cohort study based on linked population data.
    BMC Emerg Med 2017 Mar 23;17(1):12. Epub 2017 Mar 23.
    Faculty of Health, University of Technology Sydney, Ultimo, 2007, Australia.
    Background: To investigate the impact of presenting to an Emergency Department (ED) during pregnancy on postnatal depression (PND) in women in New South Wales (NSW), Australia.

    Method: An epidemiological population-based study using linked data from the NSW Emergency Department Data Collection (EDDC), the NSW Perinatal Data Collection (PDC) and the NSW Admitted Patients Data Collection (APDC) was conducted. Women who gave birth to their first child in NSW between 1 January 2006 and 31 December 2010 were followed up from pregnancy to the end of the first year after birth. Read More

    Sepsis recognition in the emergency department - impact on quality of care and outcome?
    BMC Emerg Med 2017 Mar 23;17(1):11. Epub 2017 Mar 23.
    Department of Medicine D, Division of General Internal Medicine, Nephrology, and Rheumatology, University Hospital Münster, Albert-Schweitzer-Strasse 33, 48149, Münster, Germany.
    Background: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED).

    Methods: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Read More

    Prevalence and predictors of intra-abdominal hypertension and compartment syndrome in surgical patients in critical care units at Kenyatta National Hospital.
    BMC Emerg Med 2017 Mar 23;17(1):10. Epub 2017 Mar 23.
    Department of Anaesthesia and Critical Care, Kenyatta National Hospital, P. O. Box 20723-00202, Nairobi, Kenya.
    Background: Intra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatta National Hospital (KNH) critical care units is not known. Read More

    Aerial medical evacuation of health workers with suspected Ebola virus disease in Guinea Conakry-interest of a negative pressure isolation pod-a case series.
    BMC Emerg Med 2017 Mar 11;17(1). Epub 2017 Mar 11.
    Alliance for International Medical Action, Dakar, Senegal.
    We report 4 cases of Health Workers (HW) suspected of having contracted Ebola Virus Disease (EVD), transported from the Alliance for International Medical Action (ALIMA) Ebola Treatment Centre (ETC) in N'Zerekore, Guinea to the Treatment Centre for Carers run by the medical corps of the French army in Conakry, the capital of Guinea, which was established on 17 January 2015 and closed on 7 July 2015. In total more than 500 HWs have died from EVD since the epidemic began. This mortality has had significant effects on the ability of local services to respond appropriately to the disaster. Read More

    Effectiveness of a community paramedic-led health assessment and education initiative in a seniors' residence building: the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS).
    BMC Emerg Med 2017 Mar 9;17(1). Epub 2017 Mar 9.
    Departments of Family Medicine, Clinical Epidemiology and Biostatistics, Quality Assurance Program Coordinator for Family Medicine Residency, Residency Program Research Coordinator, Family Medicine Residency Program, McMaster University, 100 Main Street West, 5th Floor, Hamilton, ON, L8P 1H6, Canada.
    Background: Seniors living in subsidized housing have lower income, poorer health, and increased risk for cardiometabolic diseases and falls. Seniors also account for more than one third of calls to Emergency Medical Services (EMS). This study examines the effectiveness of the Community Health Assessment Program through EMS (CHAP-EMS) in reducing blood pressure, diabetes risk, and EMS calls. Read More

    Improved recognition of ineffective chest compressions after a brief Crew Resource Management (CRM) training: a prospective, randomised simulation study.
    BMC Emerg Med 2017 Mar 3;17(1). Epub 2017 Mar 3.
    PHV-Dialysezentrum Waiblingen, Beinsteiner Str. 8/3, 71334, Waiblingen, Germany.
    Background: Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patient outcomes. We investigated the effect of a brief Crew Resource Management (CRM) training program on the correction rate of improperly executed chest compressions in a simulated cardiac arrest scenario. Read More

    A review of enhanced paramedic roles during and after hospital handover of stroke, myocardial infarction and trauma patients.
    BMC Emerg Med 2017 Feb 23;17(1). Epub 2017 Feb 23.
    Institute of Neuroscience (Stroke Research Group), Newcastle University, Newcastle upon Tyne, United Kingdom.
    Background: Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. Read More

    A nationwide survey of first aid training and encounters in Norway.
    BMC Emerg Med 2017 Feb 23;17(1). Epub 2017 Feb 23.
    Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, IKM, University of Tromsø, 9037, Tromsø, Norway.
    Background: Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish the prevalence and distribution of first aid training in the populace, how often first aid skills are needed, and self-reported helping behaviour. Read More

    A qualitative study to identify barriers to deployment and student training in the use of automated external defibrillators in schools.
    BMC Emerg Med 2017 Jan 19;17(1). Epub 2017 Jan 19.
    Centre for Intervention Research, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2, DK-1353, Copenhagen, Denmark.
    Background: Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates have been observed, and even at schools with a defibrillator, challenges such as delayed access have been reported. The purpose of this study was to identify barriers to the implementation of defibrillator training of students and deployment of defibrillators in schools. Read More

    Emergency department presentations for atrial fibrillation and flutter in Alberta: a large population-based study.
    BMC Emerg Med 2017 Jan 10;17(1). Epub 2017 Jan 10.
    Women & Children's Health Research Institute, Edmonton, Canada.
    Background: Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of AFF presentations and outcomes after ED discharge in Alberta.

    Methods: Provincial administrative databases were used to obtain all primary ED encounters for AFF during 1999 to 2011 for patients aged >35 years. Read More

    Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study.
    BMC Emerg Med 2017 Jan 7;17(1). Epub 2017 Jan 7.
    Directorate of Road Traffic and Road Safety, Uganda Police Force, Kampala, Uganda.
    Background: The Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in motorized vehicles which, predisposes the region to a high risk of road traffic incidents (RTIs). A number of concerted road safety and post-crash management measures to respond to RTIs in the KMA in particular and Uganda as a whole have been undertaken. Read More

    Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis.
    BMC Emerg Med 2016 Dec 7;16(1):47. Epub 2016 Dec 7.
    Faculty of Health and Life Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol, BS16 1DD, UK.
    Background: Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical care teams (CCTs) which attend critically ill patients, including OHCA. However, current scientific evidence describing CCTs attending OHCA is sparse and research to date has not demonstrated clear benefits from this model of care. Read More

    The Sydney Triage to Admission Risk Tool (START) to predict Emergency Department Disposition: A derivation and internal validation study using retrospective state-wide data from New South Wales, Australia.
    BMC Emerg Med 2016 Dec 3;16(1):46. Epub 2016 Dec 3.
    The George Institute for Global Health, The University of Sydney, Sydney, NSW, Australia.
    Background: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making.

    Methods: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Read More

    Brief compression-only cardiopulmonary resuscitation training video and simulation with homemade mannequin improves CPR skills.
    BMC Emerg Med 2016 Nov 29;16(1):45. Epub 2016 Nov 29.
    Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, 4170 City Avenue, Philadelphia, PA, 19131, USA.
    Background: Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fee; which can dissuade many potential bystanders from receiving training. This study aimed to evaluate the effectiveness of teaching compression-only CPR to previously untrained individuals using our 6-min online CPR training video and skills practice on a homemade mannequin, reproduced by viewers with commonly available items (towel, toilet paper roll, t-shirt). Read More

    Testing a videogame intervention to recalibrate physician heuristics in trauma triage: study protocol for a randomized controlled trial.
    BMC Emerg Med 2016 Nov 11;16(1):44. Epub 2016 Nov 11.
    Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
    Background: Between 30 and 40 % of patients with severe injuries receive treatment at non-trauma centers (under-triage), largely because of physician decision making. Existing interventions to improve triage by physicians ignore the role that intuition (heuristics) plays in these decisions. One such heuristic is to form an initial impression based on representativeness (how typical does a patient appear of one with severe injuries). Read More

    Intranasal ketamine for acute traumatic pain in the Emergency Department: a prospective, randomized clinical trial of efficacy and safety.
    BMC Emerg Med 2016 Nov 9;16(1):43. Epub 2016 Nov 9.
    Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, 64239, Israel.
    Background: Ketamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study was to elucidate the efficacy and adverse effects of a sub-dissociative dose of IN Ketamine compared to IV and IM morphine. Read More

    Retrospective analysis of management of ingested foreign bodies and food impactions in emergency endoscopic setting in adults.
    BMC Emerg Med 2016 Nov 4;16(1):42. Epub 2016 Nov 4.
    Operative Unit of General and Thoracic Surgery, University of Palermo, Palermo, Italy.
    Background: Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014.

    Methods: This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. Read More

    Comparison of antimicrobial resistance patterns of ESBL and non ESBL bacterial isolates among patients with secondary peritonitis at Bugando Medical Centre, Mwanza - Tanzania.
    BMC Emerg Med 2016 Oct 21;16(1):41. Epub 2016 Oct 21.
    Department of Surgery, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
    Background: Secondary peritonitis is a common surgical emergence with deadly outcomes when not timely and promptly intervened. The emergence of Extended spectrum beta lactamase producing bacteria (ESBL) poses treatment challenge at Bugando Medical Centre (BMC); hence a need to evaluate the magnitude of ESBL so as to guide specific therapy.

    Methods: This was a cross sectional study conducted at BMC from May 2014 to April 2015 involving patients with secondary peritonitis. Read More

    Dispatch guideline adherence and response interval-a study of emergency medical calls in Norway.
    BMC Emerg Med 2016 Oct 13;16(1):40. Epub 2016 Oct 13.
    Department of Research, Norwegian Air Ambulance Foundation, PB 94, 1441, Drøbak, Norway.
    Background: The Emergency Medical Communication Centre (EMCC) operators in Norway report using the Norwegian Index for Medical Emergency Assistance (Index), a criteria-based dispatch guideline, in about 75 % of medical emergency calls. The main purpose of a dispatch guideline is to assist the operator in securing a correct response as quickly as possible. The effect of using the guideline on EMCC response interval is as yet unknown. Read More

    Primary triage nurses do not divert patients away from the emergency department at times of high in-hospital bed occupancy - a retrospective cohort study.
    BMC Emerg Med 2016 Sep 22;16(1):39. Epub 2016 Sep 22.
    IKVL/Avd för medicin, Universitetssjukhuset, Hs 32, EA-blocket, plan 2, 221 85, Lund, Sweden.
    Background: Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. Read More

    Outcomes associated with observation versus short-stay admission among chest pain patients in the Veterans Health Administration.
    BMC Emerg Med 2016 Sep 21;16(1):38. Epub 2016 Sep 21.
    Iowa City Veterans Affairs Healthcare System, The Comprehensive Access and Delivery, Research and Evaluation Center (CADRE), Iowa City, IA, 52242, USA.
    Background: To determine the extent to which 30- and 90-day hospital readmission and mortality rates differ as a function of whether a chest pain patient is placed in observation status or admitted to the hospital for a short-stay (<48 h).

    Methods: Using 114,043 observation stays and short-stay admissions for chest pain at Veterans Health Administration hospitals between 2005 and 2013, we estimated event-level logistic regression models using a generalized estimating equation framework to predict 30 and 90-day readmissions and mortality as a function of whether the patient had an observation stay or a short-stay admission. We also adjusted for a variety of patient characteristics and unobserved time-invariant hospital factors. Read More

    Keep it simple: vascular risk factors and focal exam findings correctly identify posterior circulation ischemia in "dizzy" patients.
    BMC Emerg Med 2016 Sep 13;16(1):37. Epub 2016 Sep 13.
    The Johns Hopkins University School of Medicine, 600 North Wolfe St. Phipps 446C, Baltimore, 21287, MD, USA.
    Background: Dizziness is a common chief complaint of patients presenting to the Emergency Department (ED). Physicians must quickly and accurately identify patients whose etiology is most likely ischemia. Additional tools are available, but often require further training (vestibular testing) or are costly and not always readily available (magnetic resonance imaging (MRI)). Read More

    Barriers in detecting elder abuse among emergency medical technicians.
    BMC Emerg Med 2016 Sep 2;16(1):36. Epub 2016 Sep 2.
    Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA.
    Background: Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians' (EMTs), despite state-mandated reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. Read More

    The incorporation of focused history in checklist for early recognition and treatment of acute illness and injury.
    BMC Emerg Med 2016 Aug 31;16(1):35. Epub 2016 Aug 31.
    Multidisciplinary Epidemiological and Translational Research in Intensive Care, Emergency and Perioperative Medicine (METRIC-EPM), Critical Care Medicine, Mayo Clinic, Mary Brigh building, 2nd floor, 200 1st Street SW, Rochester, MN, 55905, USA.
    Background: Diagnostic error and delay are critical impediments to the safety of critically ill patients. Checklist for early recognition and treatment of acute illness and injury (CERTAIN) has been developed as a tool that facilitates timely and error-free evaluation of critically ill patients. While the focused history is an essential part of the CERTAIN framework, it is not clear how best to choreograph this step in the process of evaluation and treatment of the acutely decompensating patient. Read More

    Heart Fatty Acid Binding Protein and cardiac troponin: development of an optimal rule-out strategy for acute myocardial infarction.
    BMC Emerg Med 2016 Aug 31;16(1):34. Epub 2016 Aug 31.
    Emergency Department, Christchurch Hospital, Christchurch, New Zealand.
    Background: Improved ability to rapidly rule-out Acute Myocardial Infarction (AMI) in patients presenting with chest pain will promote decongestion of the Emergency Department (ED) and reduce unnecessary hospital admissions. We assessed a new commercial Heart Fatty Acid Binding Protein (H-FABP) assay for additional diagnostic value when combined with cardiac troponin (using a high sensitivity assay).

    Methods: H-FABP and high-sensitivity troponins I (hs-cTnI) and T (hs-cTnT) were measured in samples taken on-presentation from patients, attending the ED, with symptoms triggering investigation for possible acute coronary syndrome. Read More

    Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study.
    BMC Emerg Med 2016 Aug 24;16(1):33. Epub 2016 Aug 24.
    University Department of Internal Medicine, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland.
    Background: Psychological distress in medical patients admitted to the emergency department (ED) is not well studied. Our aim was to investigate the extent of psychological distress in a broad and unselected medical patient sample 30 days after ED admission and its association with socio-demographic and clinical variables.

    Method: We used data from a prospective observational cohort study including 1575 consecutive adult medical patients presenting to the ED with acute somatic conditions. Read More

    Early prediction of outcome after severe traumatic brain injury: a simple and practical model.
    BMC Emerg Med 2016 Aug 24;16(1):32. Epub 2016 Aug 24.
    Neuroscience Research Program, Keenan Research Center of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
    Background: Traumatic brain injury (TBI) is a heterogeneous syndrome with a broad range of outcome. We developed a simple model for long-term outcome prognostication after severe TBI.

    Methods: Secondary data analysis of a large multicenter randomized trial. Read More

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