International emergency nursing
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Ankle injuries can account for up to 3.8% of UK Emergency Department (ED) presentations per annum and this figure is comparative to the 4.4% in North America. Growing ED attendance impacts on crowding, waiting times, patient satisfaction and service provision. One way to streamline service would be widespread use of the Ottawa Ankle Rules (OAR), which reduces the need to wait for radiography. ⋯ A strong body of evidence supports OAR use in reducing radiography but further research is needed to explore impact on LoS. This would inform clinical practice and potentially combat current pressures faced within EDs worldwide.
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To ascertain the efficacy of fascia iliaca block for providing analgesia for adults with proximal femoral fractures when compared with standard management. The potential for non-medical practitioners to deliver this block was also assessed. ⋯ FICB is an effective method of providing analgesia in these patients without the undesirable side effects of systemic opioids. Non- medical practitioners are capable of administering this block.
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Review Observational Study
Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR): A mixed-methods study of simulated telephone-assisted CPR.
In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions. ⋯ Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered.
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Review
Quality of healthcare services provided in disaster shelters: An integrative literature review.
Globally, shelters are a resource to promote critical health and safety in disasters, particularly for vulnerable populations (e.g., children, elderly, chronically ill). This study examines the nature and quality of healthcare services rendered in disaster and emergency shelters. ⋯ A small number of population-based and smaller, ad hoc outcomes-based evaluation efforts exist; however the existing literature regarding systematic outcomes-based quality assessment of disaster sheltering healthcare services is notably sparse.
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The growing number of patients in emergency departments can lead to overcrowding, often adding to organisational problems. Triage aims to predict the severity of disease, with the aim of organising patient flow. The aim of this study was to analyse the efficacy of the Manchester Triage System (MTS) for risk classification of patients. ⋯ The majority of studies found that the MTS was useful in triage of patients in emergency departments, but sub-triage and super-triage (i.e. under and over classification of severity, respectively) still occur.