European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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To determine whether vital signs in patients suffering from acute pain in the out-of-hospital setting have any association with pain severity measured using an ordinal pain scale. ⋯ An association between prehospital vital signs and pain severity has been shown using ordinal logistic regression. In adults, a respiratory rate of 25 breaths/min or more was the most important predictor of having more severe pain. Tachycardia and systolic hypertension may also be important in younger and older patients, respectively. Simple correlation fails to show clinically important associations between prehospital vital signs and pain severity.
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The possible benefits of ultrasonic cardiac output monitoring (USCOM) in emergency medicine practice could be significant if evaluated in a goal-directed protocol. The aim of this study was to perform a feasibility study in a physician-staffed prehospital emergency medicine system. This study enrolled a convenient sample of 50 patients with circulatory distress. ⋯ In case of failure, the patient was very often dyspneic (80 vs. 23%, when the technique was successful, P<0.001). Mean duration of USCOM examination was 105 ± 60 s. The acceptable success rate for a new technique we observed and the high easy-to-use score suggests that the use of USCOM is feasible in prehospital emergency medicine.
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Participants in advanced resuscitation courses are often expected to learn to perform intraosseous access (IO). But how many learning modalities are needed to achieve procedural confidence in IO? We distributed an online questionnaire to members of emergency medicine, paediatric and anaesthesiology societies in Scandinavia. The responders without real-life experience with IO (n=322) were classified as 'not confident' or 'confident' in IO. ⋯ Confidence increased to 74.8% after one training modality, 87.9% after two modalities, 98.7% after three modalities and 100% after four modalities (P<0.0001). Of total responders 89.5% who had 'workshop or similar training with hands-on experience' as sole teaching method was confident. Confidence in IO increases with the number of learning modalities. 'Workshop or similar training with hands-on experience' as single training modality seemed as effective as the combination of two modalities.
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Comparative Study
Comparison of the SALT and Smart triage systems using a virtual reality simulator with paramedic students.
Virtual reality systems may allow for organized study of mass casualty triage systems by allowing investigators to replicate the same mass casualty incident, with the same victims, for a large number of rescuers. The study objectives were to develop such a virtual reality system, and use it to assess the ability of trained paramedic students to triage simulated victims using two triage systems. ⋯ The virtual reality platform seems to be a viable research tool for examining mass casualty triage. A small sample of trained paramedic students using the virtual reality system was able to triage simulated patients faster and with greater accuracy with 'Smart' triage than with 'SALT' triage.