European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study
Identification of adult septic patients in the prehospital setting: a comparison of two screening tools and clinical judgment.
Timely identification and treatment of sepsis is crucial for patient outcome. The aim of this study was to compare two previously unvalidated prehospital sepsis screening tools with clinical judgment by emergency medical services (EMS) personnel with respect to identification of septic patients. ⋯ The Robson screening tool had a sensitivity superior to both BAS 90-30-90 and clinical judgment. This supports our hypothesis that the implementation of a screening tool could lead to increased prehospital identification of sepsis, which may enable a more timely treatment of these patients.
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Observational Study
What is the 30-day rate of adverse cardiac events in chest pain patients with ED troponin I assays≤99th centile using a contemporary sensitive assay? An exploratory analysis.
For nonhigh-risk patients who 'rule out' for acute coronary syndrome, Australasian guidelines recommend further testing to identify coronary artery disease. Testing is usually performed as an outpatient procedure. This recommendation has not changed with the advent of sensitive biomarker assays. We aimed to determine the 30-day rate of adverse cardiac events in emergency department (ED) chest pain patients without known coronary artery disease who had ED troponin I (TnI) assays≤99th centile using a contemporary troponin assay, stratified by the Heart Foundation (HF; Australia) risk group. ⋯ Among ED patients presenting with suspected acute coronary syndrome, adverse cardiac events at 30 days are rare in nonhigh-risk patients with contemporary TnI assays<99th centile.
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Multicenter Study
Accuracy of oxygen tissue saturation values in assessing severity in patients with sepsis admitted to emergency departments.
Near-infrared spectrometry assesses hemoglobin saturation of oxygen in tissues (StO2). Although it may provide additional information on local microcirculation function, the usefulness of near-infrared spectrometry in septic patients is debated. This study evaluated whether baseline StO2 value is useful in septic patients admitted to the emergency department with a diagnosis of severe sepsis. ⋯ This study fails to show any value of StO2 baseline at triage for early detection of severe sepsis in emergency patients.
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Randomized Controlled Trial
Teaching basic life support: a prospective randomized study on low-cost training strategies in secondary schools.
Cardiopulmonary resuscitation (CPR) training at school is recommended. Limited school resources prevent implementation. The learning efficacy of low-cost training strategies is unknown. ⋯ Training efficacy with low-cost equipment was not different from training with a manikin. The outcome for all training strategies was suboptimal. The basics of CPR can be taught with alternative equipment if manikins are not available.
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The aim of this study was to identify a reliable tool for the early prognostic stratification of septic patients admitted to the emergency department-high dependency unit (ED-HDU), a clinical setting providing a subintensive level of care; we also estimated the cost saving associated with HDU stay compared with ICU stay. ⋯ SOFA score is a feasible and accurate tool for an early risk stratification of septic patients admitted to the ED-HDU.