European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
Efficacy of a self-learning station for basic life support refresher training in a hospital: a randomized controlled trial.
Adult basic life support refresher training using voice feedback manikins has been shown to be feasible, but the superiority of this strategy over instructor-led (IL) refresher training for nurses in a hospital has not been studied in randomized trials. ⋯ This randomized trial in a real-life setting showed that more nurses achieved adequate compression depth, 7 months after IL refresher training compared with training in a SL station. Further research is needed to improve the efficacy of this SL training strategy.
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A dental source of infection should be suspected in patients presenting with an acute cervicofacial swelling or trismus. Dental infection originates in the tooth or in the tissues that closely surround it. These infections are common and generally resolve by spontaneous drainage through the gingival tissues of the tooth. ⋯ The spread of infection can lead to life-threatening complications, such as airway compromise, cavernous sinus thrombosis, and mediastinitis. Mortality from severe dental infections, although uncommon, is increasing. The aim of this review was to describe the clinical presentation, evaluation, and management of patients presenting with severe or potentially severe dental infection.
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In acute heart failure (AHF), hemoglobin, red cell distribution width, mean platelet volume, leukocytes, and relative lymphocyte count have been associated with mortality. It is not known whether absolute blood neutrophil, eosinophil, and monocyte counts are mortality predictors. ⋯ AEC of AHF patients measured at admission was found to be a stronger predictor of mortality than all other hemogram parameters and this is consistent with the increased sympatho-adrenal activity theory.
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Comparative Study
Radiation exposure of ventilated trauma patients in intensive care: a retrospective study comparing two time periods.
To describe the cumulative effective dose of radiation that was received during the initial Emergency Department assessment and ICU stay of patients admitted with trauma, who required mechanical ventilation, during two time periods. ⋯ The radiation exposure of mechanically ventilated trauma patients in intensive care has increased over time. Radiation exposure should be prospectively monitored and staff should be aware of the increased risk resulting from this change in practice.
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Patients with hereditary angioedema may present to the emergency department (ED) with subcutaneous and submucosal swellings, the most important being the development of laryngeal oedema, which can rapidly obstruct the airways and cause death. The aim of this study was to establish whether local guidelines exist for the management of such patients and to determine where the C1 inhibitor concentrate (C1 INHC) was kept in the trusts. A questionnaire survey of the availability and use of C1 INHC was sent to 35 EDs across the UK with established immunology services within their trusts. ⋯ Only 17 departments had any guidance with regard to their use. There is a significant lack of guidance for C1 INHC use in the EDs surveyed. A guideline was developed as a result that can be used by EDs across Europe.