European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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We aimed to determine the value of sidestream end-tidal carbon dioxide (SS-ETCO2) measurement in patients with chronic obstructive pulmonary disease (COPD) in the emergency department. Cross-sectional associations between ETCO2 and PaCO2 were examined in the study. This prospective cross-sectional study has been carried out over a 3-month period in a tertiary care university hospital emergency department with an annual census of 75 000 visits. ⋯ Mean arterial PCO2 levels were 43.24±14.73 and mean ETCO2 levels were 34.23±10.86 mmHg. Agreement between PCO2 and ETCO2 measurements was 8.4 mmHg and a precision of 11.1 mmHg. As there is only a moderate correlation between PCO2 and ETCO2 levels in COPD patients, ETCO2 measurement should not be considered as a part of the decision-making process to predict PaCO2 level in COPD patients.
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Oxygen (O2) is a cornerstone in the treatment of critically ill patients, and the guidelines prescribe 10-15 l of O2/min even to those who are initially normoxic. Studies using indirect or invasive methods suggest, however, that supplemental O2 may have negative cardiovascular effects. The aim of this study was to test the hypothesis, using noninvasive cardiac magnetic resonance imaging, that inhaled supplemental O2 decreases cardiac output (CO) and coronary blood flow in healthy individuals. ⋯ Our data indicate that O2 administration decreases CO, LV perfusion and systemic and coronary O2 delivery in healthy individuals. Further research should address the effects of O2 therapy in normoxic patients.
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The epidemiology and optimal management of injury to the paediatric scaphoid (carpal navicular) is unknown.The objective of this study is to evaluate these parameters in the Emergency Department of a tertiary children's hospital. ⋯ Pain in the anatomical snuff box is a poor indicator of bone injury to the scaphoid of any sort. Scaphoid fracture is a rare injury in childhood and from this study, it is extremely unlikely to occur under the age of 9 years.The actual bone pathology of an injured paediatric scaphoid may not be clear, but these children have significant pain and tenderness. Further studies are warranted to improve the diagnostic process and the management of paediatric scaphoid injury.
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The objective of this paper was to assess the resuscitation training and knowledge status of medical and surgical residents (SRs). A questionnaire of 23 questions was answered by medical and SRs in an Athens General Hospital. The questionnaire was designed based on the 2005 resuscitation guidelines. ⋯ With regard to the knowledge questions, the mean score, on a maximum scale of 10, was 5.39±1.93 for the medical residents and 5.27±2.33 for the SRs. Their resuscitation knowledge was positively influenced by their attendance of Basic Life Support (P=0.005) and Advanced Life Support/Advanced Cardiac Life Support courses (P=0.013). Residents in this tertiary general hospital in Athens had inadequate knowledge of resuscitation guidelines and the majority of them were not currently certified in any of these courses.