European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
A mass carbon monoxide (CO) intoxication during an ice-hockey game is described. Two hundred and thirty-five patients were seen in different hospitals, 88 of them the same night at the nearby emergency department. To evaluate long-term implications and to identify relevant indicators, a follow-up study was organized 1 year after the incident. ⋯ CO mass poisonings remain a risk in indoor sporting events. Although it causes an acute mass casualty incident, it is limited in time and delayed problems are scarce. Symptomatology is a poor tool for triage. The best prevention is the use of nonmineral energy sources such as for example electricity.
-
Multicenter Study
Capability of Scottish emergency departments to provide physician-based prehospital critical care teams: a national survey.
The aim of this study was to establish the current capabilities of emergency departments in Scotland to provide a prehospital medical team at the request of the ambulance service. ⋯ The majority of emergency departments in Scotland are able to provide a prehospital team on the request of the ambulance service. There is high variability in the composition and seniority of the team, with less ability to provide a team out of hours. With two notable exceptions, the overall activation of these prehospital teams is infrequent, and there are significant improvements required with regard to the clinical governance surrounding the provision of these teams.
-
Randomized Controlled Trial Comparative Study
Reducing the potential for tourniquet-associated reperfusion injury.
Investigate a strategy to minimize tourniquet-associated reperfusion injury. ⋯ A staggered tourniquet release was associated with greater haemodynamic stability and reduced the rate of acute systemic metabolic changes associated with limb reperfusion. Reapplication of a tourniquet seemed to halt further reperfusion, providing a window period for patient evaluation and management.
-
Comparative Study
Undertreatment of pain in the prehospital setting: a comparison between trauma patients and patients with chest pain.
The aim of this study was to evaluate pain treatment with morphine administered by emergency medical service personnel (EMSP) to patients with chest pain and patients with pain in extremities because of trauma. This is a retrospective chart review of 2021 patients with chest pain and 887 patients with trauma. ⋯ Inadequate analgesia was frequently observed for both patient groups. The protocol was not fully utilized, suggesting that education in pharmacology and follow-up of the EMSP is required.
-
Alcohol withdrawal delirium (AWD) is often refractory to conventional medication. We report a prospective series of patients treated with α2-agonist dexmedetomidine added to conventional sedation. Eighteen patients with AWD were diagnosed by Confusion assessment method for ICU score. ⋯ The ICU LOS was 7.1 (2.7) days and in-hospital LOS 12.1 (4.5) days. No adverse events were observed although one patient died from acute pancreatitis. The use of dexmedetomidine in AWD seems safe but warrants further studies.