European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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A large number of people throughout Europe are involved in accidents every year. Neurological emergencies as the underlying cause of accidents are poorly investigated. This retrospective chart review study was performed to evaluate the incidence of such events. ⋯ Neurological emergencies, particularly epilepsy, stroke and intracerebral hemorrhage are causes of accidents which have to be considered more often than expected and happen most frequently in the morning. Other demographical and medical data provide no additional information for emergency medical personnel to specifically identify such patients. Nevertheless, emergency physicians seem to be highly skilled in finding the correct diagnosis.
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Mediastinal widening is a frequent radiological finding in the emergency department patient. The causes of mediastinal widening can be divided into traumatic and nontraumatic mediastinal widening. An important association of moderate to high velocity trauma is the mediastinal haematoma. ⋯ Multidetector spiral CT plays an important role (Alkadhi et al., Radiographics 2004; 24:1239-1255), but usually as a second line procedure. This article discusses the radiological signs of traumatic mediastinal widening. Different traumatic lesions resulting in a widened mediastinum are presented, and some nontraumatic causes of a widened mediastinum are shown, in order to facilitate the differentiation between both entities.
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Randomized Controlled Trial
The 50 ml syringe training aid should be utilized immediately before cricoid pressure application.
Cricoid pressure, applied during rapid sequence induction of anaesthesia, should be performed only by trained staff. Recommended training intervals vary from weekly to every 3 months, but this is unrealistic in day-to-day practice. Performance, when assessed, is often shown to be unacceptable before training. Unfortunately, most training aids are either expensive or unavailable. Assessment and training in previous studies was carried out on the same cricoid pressure simulator, introducing learning bias. In our study, we tested whether a 50 ml syringe utilized as a training aid immediately before the assessment of simulated rapid sequence induction on a different cricoid pressure simulator would improve staff performance. ⋯ Brief training with a 50 ml syringe will increase the likelihood of satisfactory force application during Sellick's manoeuvre. Applied to clinical practice, this will make cricoid pressure both more effective and reliable, and may improve patient safety. Therefore, the 50 ml syringe should be utilized before any clinical application of cricoid pressure.
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Staff in the emergency departments of hospitals are reported as being negative or ambivalent toward suicidal or self-harming individuals. According to the literature, these patients are subjected to stigmatization and lack of empathy. ⋯ In this paper, evidence suggesting staff attitudes toward suicidal and self-harming patients is reviewed. An overview of related issues such as clinical judgment, the use of scales and nurses' role is also included in this report.
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Temporary henna tattoos are a popular fashion accessory in recent years. The tattoo dye consists of henna extract from the plant Lawsonia, and p-phenylenediamine to create a darker shade to the tattoo. ⋯ I present two cases of reactions to temporary tattoos in children attending the emergency department. The acute management of these cases and the possible future consequences of sensitization to p-phenylenediamine are discussed.