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This page shows you the latest items in this publication. This is page number 2.

The annual winter surge – why are we so surprised?
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - February 27, 2015 Category: Emergency Medicine Tags: Editorial Source Type: research

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: associated factors at emergency department presentation
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: is it properly evaluated?
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Failure of noninvasive mechanical ventilation: could we assess determining factors in emergency department?
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Best approach to measuring the inferior vena cava in spontaneously ventilating patients: a pilot study
The objective of this study was to establish the reliability of different measurements of inferior vena cava (IVC) size and respiratory variation in response to changes in circulating volume. Transabdominal ultrasound measurements of the IVC were obtained in longitudinal (B and M modes) and transverse planes (B-mode height and ellipse circumference) during inspiration and expiration, and inferior vena cava collapsibility indices (IVCci) were calculated. Measurements were repeated following venesection of ∼450 ml. Thirty patients underwent venesection. Their IVCci increased significantly for transverse and longitudinal he...
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Short Reports Source Type: research

Acute testicular pain in children: collaboration in timely management
Acute scrotal pain in a child is a urological emergency. Surgeons should be involved early and exclude torsion promptly, often by surgical exploration. This short report compares the time taken by different medical practitioners [Emergency Department (ED) doctors and surgeons] to assess children presenting to the ED with acute scrotal pain. A retrospective observational study was carried out in a district general hospital ED over a 2-year period. A total of 205 children presented with testicular pain, 48 of whom were clinically diagnosed with torsion in the ED. Surgeons reviewed patients with testicular pain quicker than E...
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Short Reports Source Type: research

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: associated factors at emergency department presentation
Objective: Noninvasive ventilation (NIV) is a common practice in acute hypercapnic respiratory failure (AHRF) because of exacerbation of chronic obstructive pulmonary disease (COPD). However, a recent study has shown that patients who require invasive mechanical ventilation (IMV) after failure of NIV experience high mortality rates (up to 30%). Therefore, the aim of this study is to determine the parameters, specifically for emergency department (ED) presentation, associated with the transition from NIV to IMV because of NIV failure. Patients and methods: This is a 4-year retrospective cohort study in the EDs of two Dutch ...
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Emergency medical services interval and mortality in significant head injury: a retrospective cohort study
Conclusion: The lack of observed association between EMS interval and mortality may not preclude bypass of significant TBI patients, with concomitantly prolonged primary transfers from the scene of injury to distant specialist centres. However, given the limitations of registry data, our results should be interpreted with caution. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Direct ultrasound methods: a confirmatory technique for proper endotracheal intubation in the emergency department
Conclusion: In this study, we found acceptable sensitivity, specificity, positive predictive value, and negative predictive value for prediction of tracheal ETT placement with the use of dynamic and static ultrasonography. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Emergency medicine in Europe: looking forward to 2015
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 12, 2015 Category: Emergency Medicine Tags: Editorial Source Type: research

Rescuer’s gender-effect on the quality of chest compression during cardiopulmonary resuscitation on manikins
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Effect of rescuer’s sex on the quality of chest compression during cardiopulmonary resuscitation on manikins
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: associated factors at emergency department presentation
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: is it properly evaluated?
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Failure of noninvasive mechanical ventilation: could we assess determining factors in emergency department?
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Correspondence Source Type: research

Sex differences in the effort indicators during cardiopulmonary resuscitation manoeuvres on manikins
The aims of this study were to examine sex differences in college students while they performed cardiopulmonary resuscitation (CPR) on a manikin for 20 min in (a) objective and subjective effort indicators and (b) to analyse the influence of potential confounders (age, BMI and cardiorespiratory fitness) on these sex differences. Sixty-three participants were recruited. Participants performed 20 min of CPR on a manikin. During the CPR trial, percentages of maximal heart rate levels were higher in women than in men (P (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Short Reports Source Type: research

Best approach to measuring the inferior vena cava in spontaneously ventilating patients: a pilot study
The objective of this study was to establish the reliability of different measurements of inferior vena cava (IVC) size and respiratory variation in response to changes in circulating volume. Transabdominal ultrasound measurements of the IVC were obtained in longitudinal (B and M modes) and transverse planes (B-mode height and ellipse circumference) during inspiration and expiration, and inferior vena cava collapsibility indices (IVCci) were calculated. Measurements were repeated following venesection of ∼450 ml. Thirty patients underwent venesection. Their IVCci increased significantly for transverse and longitudinal he...
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Short Reports Source Type: research

Acute testicular pain in children: collaboration in timely management
Acute scrotal pain in a child is a urological emergency. Surgeons should be involved early and exclude torsion promptly, often by surgical exploration. This short report compares the time taken by different medical practitioners [Emergency Department (ED) doctors and surgeons] to assess children presenting to the ED with acute scrotal pain. A retrospective observational study was carried out in a district general hospital ED over a 2-year period. A total of 205 children presented with testicular pain, 48 of whom were clinically diagnosed with torsion in the ED. Surgeons reviewed patients with testicular pain quicker than E...
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Short Reports Source Type: research

Intubation after noninvasive ventilation failure in chronic obstructive pulmonary disease: associated factors at emergency department presentation
ObjectiveNoninvasive ventilation (NIV) is a common practice in acute hypercapnic respiratory failure (AHRF) because of exacerbation of chronic obstructive pulmonary disease (COPD). However, a recent study has shown that patients who require invasive mechanical ventilation (IMV) after failure of NIV experience high mortality rates (up to 30%). Therefore, the aim of this study is to determine the parameters, specifically for emergency department (ED) presentation, associated with the transition from NIV to IMV because of NIV failure. Patients and methodsThis is a 4-year retrospective cohort study in the EDs of two Dutch hosp...
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Emergency medical services interval and mortality in significant head injury: a retrospective cohort study
ConclusionThe lack of observed association between EMS interval and mortality may not preclude bypass of significant TBI patients, with concomitantly prolonged primary transfers from the scene of injury to distant specialist centres. However, given the limitations of registry data, our results should be interpreted with caution. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

A study of hypothermic patients presenting to a Mediterranean emergency department
BackgroundA retrospective chart review was carried out in the adult Emergency Department of Mater Dei Hospital in the ‘sunny warm Mediterranean island’ Malta, on patients admitted with a rectal temperature of less than 35°C during the two consecutive winters of 2010–2011 and 2011–2012. ObjectiveThe aim of this study was to find any correlation among patients presenting with hypothermia and the weather conditions, age and residential background. We also studied their mortality outcomes. MethodsAll patient data were collected from the Emergency Department’s medical records and patients’ case notes. All 199 patie...
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Efficiency and safety of a noninvasive therapeutic hypothermia protocol in cardiac arrest
ConclusionThis noninvasive TH procedure seems efficient and safe in all patients remaining comatose after CA. Thanks to its simplicity, it could allow prehospital cooling to reach the target temperature more rapidly. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Elevated lactate level and shock index in nontraumatic hypotensive patients presenting to the emergency department
BackgroundThe aim of our study was to evaluate the effect of lactate level (LL) and shock index (SI) on the outcome in nontraumatic hypotensive patients in the emergency department, and also to show the significance of the combined usage of these two parameters. MethodsThis is a prospective, observational study. Elevated and normal LL (ELL and NLL), elevated and normal SI (ESI and NSI), and a combination of these two parameters (lactate–SI group 1: ELL and ESI, lactate–SI group 2: ELL or ESI, and lactate–SI group 3: NLL and NSI) were evaluated for primary (mortality) and secondary outcome measures. ResultsA total of ...
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Difficulties encountered by physicians in interpreting focused echocardiography using a pocket ultrasound machine in prehospital emergencies
ConclusionAfter a very short training program, echocardiography using a PUD in prehospital emergencies was feasible in half of patients. Acquisition of technical skills is reasonable, but accurate evaluation of cardiac function may require more extensive training. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Direct ultrasound methods: a confirmatory technique for proper endotracheal intubation in the emergency department
ConclusionIn this study, we found acceptable sensitivity, specificity, positive predictive value, and negative predictive value for prediction of tracheal ETT placement with the use of dynamic and static ultrasonography. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Original Articles Source Type: research

Emergency ultrasound of acute scrotal pain
Patients presenting with acute scrotal pain to the emergency department require a timely diagnosis. Although the differential diagnosis can be extensive and varies with age, there are a few conditions that are considered true surgical emergencies. These include torsion of the spermatic cord, incarcerated hernia with strangulation, testicular trauma leading to rupture or organ-threatening hematomas, and Fournier’s gangrene. These are conditions that need to be kept in mind by the physician when approaching such patients. Other causes such as epididymitis or orchitis need to be distinguished, and although not requiring eme...
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Review Article Source Type: research

Emergency medicine in Europe: looking forward to 2015
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - January 3, 2015 Category: Emergency Medicine Tags: Editorial Source Type: research

Best Abstracts from the Eight European Congress on Emergency Medicine Congress held in Amsterdam, The Netherlands, 28 September to 1 October 2014.
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: ABSTRACTS: PDF Only Source Type: research

Are our nondoctor, non-nursing healthcare workers trained and prepared to respond to a cardiac arrest?
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Correspondence Source Type: research

Management of the Toddler’s fracture with and without initial radiological evidence
Toddler’s fracture (TF) occurs in young children after minor trauma. Clinical diagnosis can be challenging and initial radiological evidence may be lacking. The aim of this study was to compare the management and outcomes of clinically diagnosed TF patients with and without initial radiological evidence. A retrospective cohort study of patients aged between 9 and 36 months treated for TF in a Scottish Paediatric Emergency Department was conducted. Patients with a radiologically confirmed TF were more likely to be placed in a cast than those with a presumptive clinical TF diagnosis (92 vs. 47%; P (Source: European Journal...
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Things that go bump in the day or night: the aetiology of infant head injuries presenting to a Scottish Paediatric Emergency Department
The aim of this study was to describe the aetiology and severity of head injury in an infant (age (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Use of fluoroquinolones and third-generation cephalosporins in the emergency department: an 11-year survey
Fluoroquinolones and third-generation cephalosporins are particularly prone to select bacterial resistance to antibiotics. We aimed to assess the temporal trends of antibiotic use in the emergency department adults unit of an academic hospital between 2002 and 2012. Antibiotic use was converted in defined daily doses (DDD). The total antibiotic consumption tended to decrease, from 53.1±8.5 to 48.6±11.9 DDD/1000 patient visits (estimate decrease per year, −0.9±0.5 DDD/1000 visits, P=0.07). Use of third-generation cephalosporins increased significantly, from 9.7% of total antibiotic use to 22.6% (estimate per year, 1.2...
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Chest auscultatory signs in infants presenting to A&E with bronchiolitis
ConclusionClinical signs associated with bronchiolitis vary according to age. Infants older than 6 months are more likely to present with wheeze and infants less than 4 months old are likely to present without chest signs on auscultation. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Original Articles Source Type: research

Reduction of mortality in community-acquired pneumonia after implementing standardized care bundles in the emergency department
We examined whether introduction of standardized care bundles and checklists in the ED is associated with reduced mortality in patients hospitalized for CAP. MethodsWe retrospectively analyzed performance indicators of 2819 consecutive patients with CAP admitted to the Nuremberg Hospital, Germany, from 2008 to 2009. At the turn of the year, CAP care bundles were implemented including interprofessional education, check lists, and institutionalized feedback. Primary endpoint was in-hospital mortality of CAP patients. The secondary endpoint was mortality in the subgroups of CRB-65 risk classes (C, mental confusion; R respirat...
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Original Articles Source Type: research

Magical manoeuvre: a 5-s instructor’s intervention helps lightweight female rescuers achieve the required chest compression depth
BackgroundAdequate chest compression (CC) depth is crucial for resuscitation outcomes. Lightweight rescuers, particularly women, are often unable to achieve the required 5–6 cm CC depth. This nonrandomized cohort study investigated new strategies to improve CC performance. ObjectiveTo evaluate the effects of a 5-s instructor’s intervention on the depth of CCs performed by female rescuers during standard video self-instruction basic life support training. MethodsData were prospectively collected from January 2011 to January 2012 from 336 female medical and pharmacy students undergoing cardiopulmonary resuscitation (CPR)...
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Original Articles Source Type: research

Anaesthesiologist-provided prehospital airway management in patients with traumatic brain injury: an observational study
ConclusionThe guideline adherence was high. The incidences of post-RSI hypoxia and systolic blood pressure below 90 compare with the results reported from other physician-staffed prehospital services. The incidence of systolic blood pressure below 120 as well as that of hyperventilation following prehospital endotracheal intubation in patients with traumatic brain injury call for a change in our current practice. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Original Articles Source Type: research

Quality of resuscitation by first responders using the ‘public access resuscitator’: a randomized manikin study
ConclusionCompared with the face mask, PAR improved tidal volume, compressions per minute and hand position in a manikin setting. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Original Articles Source Type: research

Base excess, strong ion difference, and expected compensations: as simple as it is
The main purpose of this article is to provide some practical insights into acid–base disorders interpretation, comparing the three most widespread diagnostic approaches. After a brief summary of the history of blood gas analysis and the shift from a purely chemical approach to more clinically useful applications, the pros and cons of the different methodologies are compared and discussed. Reviewing the most important publications in the field, the authors attempt to show that each diagnostic strategy is acceptable, although the one based on base-excess calculation perhaps seems too ‘rough’ to understand the mixed di...
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Review Articles Source Type: research

Heart failure with preserved ejection fraction: echocardiographic VALVE protocol for emergency physicians
This article discusses basic echocardiographic principles of diastolic dysfunction that can be learned and implemented in the emergency department. These findings can aid in the recognition of patients who present with heart failure with preserved ejection fraction. The authors will discuss a focused stepwise approach, namely the VALVE protocol, suitable for the fast-paced emergency department. (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Review Articles Source Type: research

Coming together to advance the specialty of emergency medicine in Europe
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 29, 2014 Category: Emergency Medicine Tags: Editorial Source Type: research

Emergency medicine: diagnosis and management (sixth edition): Retraction
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Retraction Source Type: research

Toxicology Handbook
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Book Review Source Type: research

Dexmedetomidine in addition to benzodiazepine-based sedation in patients with alcohol withdrawal delirium
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Correspondence Source Type: research

Retinal imaging: a first report of the retinal microvasculature in acute mild traumatic brain injury
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Correspondence Source Type: research

Limiting acute respiratory distress syndrome in the emergency department: a survey of US academic emergency medicine physicians
No abstract available (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Correspondence Source Type: research

The paediatric psychiatric emergency population in a university teaching hospital in Belgium (2003–2008)
This study provides a clinical and demographic profile of this population and its service use in a European context. From 2003 to 2008, we registered 989 paediatric psychiatric patients consulting the psychiatric emergency services (PES) of a large university hospital in Belgium. During this period the number of patients increased more than three-fold. Patients were predominantly female (57.3%) and adolescent (83.3%) and mostly referred for hostility and violence towards others (18.5%) and suicidal ideation (17.8%). For about 1/4 of the patients, PES was the first ever mental health treatment contact. PES could serve as a ...
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Acute complications and outcomes of acute head injury in adult patients with haemophilia
The aim of the present study is to describe the clinical and epidemiological characteristics, complications and outcome of patients with haemophilia and acute head injury (AHI) at the emergency department (ED), and develop a protocol to prevent early and late complications. This is a retrospective cohort study including all patients with haemophilia and AHI admitted to the ED. We identified 26 patients with AHI. A computed tomography scan was carried out on all patients at admission, and again on two patients (with neurosurgical complications) 48 h later. The discharge diagnosis was as follows: 3.8% subdural haematoma, 3.8...
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Transfer of obese patients in European air ambulances
The prevalence of obesity is rising worldwide. To investigate how fixed-wing air ambulances handle bariatric transfers, we conducted a survey addressing logistical and medical issues. A questionnaire was sent to 24 air ambulance companies in Europe. Seventy-nine percent of European companies returned the questionnaire, 95% of the companies consider the transfer of heavyweight patients challenging, and 21% have experienced critical incidents related to the patient’s obesity. Forty-seven percent have standard operating procedures in place for bariatric transports. Only 26% will dispatch extra personnel for such flights. De...
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Rhythm recognition is accountable for the majority of hands-off time during cardiopulmonary resuscitation – a simulation study
Cardiopulmonary resuscitation guidelines are constantly optimized to increase survival. Keeping hands-off time brief is vital. Our hypothesis is that rhythm recognition is time-consuming during cardiopulmonary resuscitation. A Laerdal Sim-Man simulated three shockable and four nonshockable rhythms. Rhythms were presented to physicians who identified whether they were shockable and whether they would defibrillate. We measured time to stated decision. Thirty-five doctors participated, 32 had completed advanced life support training. The mean time to make a decision on whether to defibrillate or not was 3.4 s [95% confidence ...
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research

Emergency airway management by paramedics: comparison between standard endotracheal intubation, laryngeal mask airway, and I-gel
The aim of this study was to investigate whether briefly trained paramedics would be able to successfully intubate by endotracheal intubation (ETI) and using the laryngeal mask airway (LMA) and the I-gel in a manikin model. After the completion of a questionnaire, a brief educational session, and presentation of ETI, LMA, and I-gel, 72 paramedics were randomly allocated to intubate an adult manikin. The success rate for I-gel was higher than that for LMA (P (Source: European Journal of Emergency Medicine)
Source: European Journal of Emergency Medicine - October 1, 2014 Category: Emergency Medicine Tags: Short Reports Source Type: research