European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The aim of this study was to investigate the care practices surrounding end-of-life patients and the scope for providing palliative care in two emergency department short-stay units. Two qualitative methods of investigation were used: direct ethnographic-type observation and semi-directed group interviews. The results highlight the fact that end-of-life situations inflect the practices of care and give rise to adjustments in the organization of work. ⋯ We propose a typology of end-of-life patients. In conclusion, the practices, termed 'palliative care' by the caregivers, are addressed to terminally ill patients expected to die shortly. This issue should be debated within emergency departments.
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We aimed to explore emergency department (ED) patients', doctors', and nurses' knowledge and illness perception with regard to prediabetes and type 2 diabetes mellitus (T2DM), and to determine whether patients' diabetes risk was associated with illness perception. ⋯ Knowledge of prediabetes is poor among ED patients and many are unaware that T2DM may be asymptomatic. Patients and clinicians perceived lifestyle factors to be causative for T2DM, but both perceived patients as having little control over the condition. The capacity of lifestyle modifications to alter the course of T2DM should be emphasized in future education programs.
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Use of the Valsalva manoeuvre (VM) as a first-line management tool for the reversion of supraventricular tachycardia (SVT) in both emergency medicine and prehospital emergency-care settings has presented challenges, requiring continuous examination and refinement to define both its appropriateness and effectiveness. This report details the evolution of knowledge related to SVT and the historical evolution and controversies associated with VM; it also highlights the ongoing development of an evidence-based model of practice for the management of SVT in the emergency medicine and prehospital emergency-care settings. A two-part review of the literature using electronic medical databases was conducted. ⋯ An evidence-based model of practice requires clarification. The differentiation of nodal re-entrant tachycardias may, with further research, lead to identification of the specificity of VM in reversion of SVT during the early stages of arrhythmia. There is a need for further prehospital and emergency department research to quantify an evidence-based approach to VM.
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Emergency cases for resuscitation include built-in oxygen cylinders with limited oxygen supply. The use of a bag-valve mask device (BVMD) with a reservoir requires a high constant flow of oxygen to maintain a high concentration of delivered oxygen. The goal of the study was to analyze what fraction of inspired oxygen (FiO2) can be reached and how long it takes using different BVMD with their reservoir device and different oxygen flows in order to allow a reduction in oxygen requirements during simulated cardiopulmonary resuscitation (CPR). ⋯ The mean FiO2 was lower with the Mark IV (P<0.05) (Table 1). To allow a substantial reduction in oxygen requirements, a 10 l/min for 1 min, followed by 5 l/min of oxygen flow can be used during CPR with both BVMDs studied. Increasing supplemental oxygen flow did not appreciably increase the FiO2.