European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Over a 3-year period, 663 children aged under 13 years were seen with a history of foreign body (FB) ingestion. Seventy-six per cent of the children were less than 6 years old. Coins and chicken or fish bones were the most common objects ingested. ⋯ All 224 FBs detected in the stomach or beyond were allowed to pass naturally, and delayed passage occurred in only one case. Passage of 11 alkaline disc batteries occurred without complication. No patient required surgical removal of an FB.
-
The very early handling of patients with suspected acute myocardial infarction (AMI) is of critical importance to the outcome. The aim of this study was to relate the dispatcher's initial suspicion of AMI, among patients who call for an ambulance due to chest pain, to the subsequent diagnosis and outcome. All patients who called for an ambulance in Gothenburg due to acute chest pain during a 2-month period were included in the study. ⋯ Among patients with at least a strong suspicion of AMI, 29% subsequently developed infarcation, compared with 18% among patients with a moderate suspicion of AMI and 15% among patients with only a vague or no suspicion (p < 0.001). However, the priority level was similar in patients with and without a life-threatening condition, and the mortality rate remained similar in patients with a strong suspicion and those without a strong suspicion of AMI. Thus, among patients who called for an ambulance due to acute chest pain there was a direct relationship between the dispatcher's suspicion of AMI and the subsequent diagnosis, but the mortality rate was similar in the different groups.
-
In the Netherlands, neonatal intensive care is provided in 10 neonatal intensive care centres. Although antenatal transport is preferred, each year more than 1000 newborns are transported to the centres, in the majority of cases by ambulance. Transport by helicopter became available in 1987. ⋯ The transports carried out from 1987 to 1989 were recalculated with regard to duration and cost, assuming they were carried out by ambulance instead of by helicopter: for the babies, the mean transport time by helicopter was 75% less than the calculated mean transport time by ambulance. However, the financial costs per transport were on average Dutch florins (DFL) 3000 higher by helicopter than by ambulance. In the Netherlands, the use of a helicopter for neonatal transport reduces the transport time, but doubles the costs.
-
Clinical Trial
Patients intoxicated with heroin or heroin mixtures: how long should they be monitored?
Our investigation was carried out in subjects intoxicated with heroin or heroin mixtures to find out the time interval during which delayed life-threatening complications become manifest, such as pulmonary oedema or relapse into respiratory depression or coma after naloxone treatment. We studied prospectively all drug intoxications between 1991 and 1992. Of the 538 intoxications, we assessed in detail 160 outpatients who lived within the catchment area of our hospital. ⋯ Based on reliable report, the pulmonary oedema occurred between approximately 2 1/4 and 8 1/4 hours after intoxication. In the literature, only two cases of delayed pulmonary oedema have been reported with reliable time statements (4 and 6 h after hospitalization). We therefore conclude that surveillance for at least 8 h is essential after successful treatment to exclude delayed pulmonary oedema in patients intoxicated with heroin or heroin mixtures.