European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Angioedema is characterized by localized swelling of subcutaneous tissues or mucosa of the upper respiratory or gastrointestinal tract. Laryngeal involvement may threaten airway patency and can be fatal if not addressed promptly. ⋯ In the emergency department, it is essential not only that acute angioedema is identified as quickly as possible but also that the likely working diagnosis is established so that the most effective treatment may be administered to resolve potentially life-threatening swelling. In this paper, we present an overview of the various types of angioedema, and offer a practical diagnostic and therapeutic approach to their management.
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We aimed to evaluate the predictive value of pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure, respiratory rate (RR), oxygen saturation (SaO2), and the Glasgow Coma Scale (GCS) for cardiac arrest and death in critically ill patients. ⋯ Not all vital signs are useful in the prediction of clinical outcomes. Vital signs had high specificity but very low sensitivity as predictors of clinical outcomes. Clinicians should always remember to treat patients and not numbers.
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Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. ⋯ The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims.
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To investigate whether patients came directly to the emergency department (ED) or whether they had taken any other actions or activities within the healthcare system before attending the ED. An additional aim was to increase our understanding of the potential determinants between patients' ED-seeking behaviour and patient-related data. ⋯ A large proportion of ED patients sought previous healthcare before seeking care at the ED. Female patients and patients with longer symptom duration more often sought other caregivers before seeking ED care.
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The intra-aortic balloon pump (IABP) was first introduced in 1968 to augment cardiac output in the haemodynamically unstable patient and serve as a bridge to treatment options such as coronary artery bypass grafting and cardiac transplantation. Transfer of IABP-dependent patients for upgrade of clinical care is increasingly common and safe. In Australia, percutaneous coronary intervention centres can be located outside cardiothoracic surgical centres. This study reviews IABP medical retrieval by a doctor/paramedic team after implementation of a standardized protocol. ⋯ Our system offers a safe method of IABP medical retrieval. The doctor and paramedic combination complements strengths in logistics and critical care. This serves as a guide to other systems looking to put in place a similar model of care.