The American journal of emergency medicine
-
Identification of predictors of outcome at the scene of drowning events could guide prevention, care and resource utilization. This review aimed to describe where, what and how scene predictive factors have been evaluated in drowning outcome studies. ⋯ Gaps to be addressed in drowning outcomes research include data from low- and middle-income countries, standardized definition of factors to allow evaluation across studies, inclusive study populations that can be generalized beyond those receiving medical care, study rescue and resuscitation factors, use of more meaningful outcomes (survival with good neurologic status) and advanced analyses to identify which factors are true predictors versus confounding variables.
-
Randomized Controlled Trial Comparative Study
Quick cuts: A comparative study of two tools for ring tourniquet removal.
Ring tourniquet occurs when a ring becomes entrapped due to swelling or trauma. As the finger expands the blood flow restriction causes additional swelling, which can lead to nerve damage and other complications. Ring tourniquet can be an emergency that requires rapid ring removal. Standard devices for ring removal have been described but rarely tested. We conducted a randomized study to compare removal time, user and participant satisfaction and complications between a motorized diamond disc ring cutter (MDDRC) and a ring cutter attached to trauma shears (TS). ⋯ This study is the first to compare efficacy, satisfaction and complications of two standard tools for removal of ring tourniquets. The TS took significantly less time than the GEM MDDRC and demonstrated significantly better satisfaction for both the ring wearer and ring remover.
-
Multicenter Study Comparative Study
The impact of COVID-19 lockdown measures on ED visits in Lebanon.
As the COVID-19 pandemic spread globally, emergency departments (ED) around the world began to report significant drops in volumes and changes in disease patterns. During the early COVID-19 period, Lebanon followed an aggressive containment approach to halt the spread of the disease. ⋯ ED visits dropped significantly during the COVID-19 containment period. Understanding the trends of changes in disease entities is important for ED staffing purposes during the pandemic and the varying containment efforts. While stringent lockdown measures were associated with drops in ED visits, understanding the reason behind these drops, specifically whether behavioral or related to true drops in disease prevalence, needs further exploration.
-
Multicenter Study
First-to-second antibiotic delay and hospital mortality among emergency department patients with suspected sepsis.
To evaluate whether delay between the first and second antibiotic administered for suspected sepsis is associated with hospital mortality. ⋯ First-to-second antibiotic delay of greater than one hour was associated with an increased risk of hospital death among patients meeting criteria for septic shock but not all patients with suspected sepsis. Tracking and improving first-to-second antibiotic delays may be considered in septic shock.