European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study Observational Study
The Icatibant Outcome Survey: treatment of laryngeal angioedema attacks.
To characterize the management and outcomes of life-threatening laryngeal attacks of hereditary angioedema (HAE) treated with icatibant in the observational Icatibant Outcome Survey (NCT01034969) registry. ⋯ This analysis describes successful use of icatibant for the treatment of laryngeal HAE attacks in a real-world setting.
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Multicenter Study Observational Study
The management of cellulitis in emergency departments: antibiotic-prescribing practices and adherence to practice guidelines in Ireland.
There is a lack of evidence to guide the management of cellulitis in the emergency department (ED). The primary aim of this study was to characterize antibiotic-prescribing practices for the treatment of cellulitis in Irish EDs. Secondary aims were to identify patient variables associated with the prescription of intravenous (i.v.) antibiotics and to describe the utility of three published guidelines for the management of cellulitis in the ED. ⋯ In Ireland, current prescribing practices for CREST 1 and modified CREST 1 and 2 patients are poorly adherent to guideline recommendations.
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Randomized Controlled Trial Multicenter Study Comparative Study
Weaker compressions after night shift? The WeCAN manikin study.
To assess whether the quality of chest compressions (CC) differs before and after a night shift. We carried out a cluster randomized study in three Emergency Departments and three ICUs in Paris, France. Physicians were assessed on a control day and immediately following after a night shift. ⋯ The proportion of CC with a depth greater than 50 mm was similar on a control day and after a night shift [52% in both groups, mean difference of 0 (95% confidence interval: -17 to 17)]. Other indicators of CC quality were unchanged after a night shift, except for the mean depth of CC (51 vs. 48 mm, P=0.01). We report in our sample that the quality of CC after a night shift is not inferior to a control day.
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Multicenter Study
Agreement between ambulance and hospital records for information promoting urgent stroke treatment decisions.
Rapid decision-making during acute stroke care can improve outcomes. We wished to assess whether crucial information to facilitate decisions is routinely collected by emergency practitioners before hospital admission. ⋯ In a retrospective cohort of stroke patients admitted by emergency ambulance, standard practice did not consistently result in prehospital documentation of information that could promote rapid treatment decisions. Training emergency practitioners and/or providing clinical protocols could facilitate early stroke treatment decisions, but prehospital information availability is likely to be a limiting factor.
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Multicenter Study
Fascia iliaca compartment block for hip fractures: experience of integrating a new protocol across two hospital sites.
Fascia iliaca compartment block (FICB) administered through the loss of resistance technique effectively reduces pain and opiate requirement in elderly patients with hip fractures. FICB is a simple technique and is easily taught. This paper plots the implementation of FICB in two hospitals. ⋯ Organizational learning of this simple procedure can be achieved through a multidisciplinary approach, and committed departmental education and feedback. The impact on length of stay and mortality were striking; however, there may be other confounding factors. Only two cases of true anaesthetic toxicity occurred in 1586 patients. The authors conclude that FICB is a safe procedure and a useful adjunct for preoperative pain control in patients with hip fractures.