European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Multicenter Study Clinical Trial
Evaluation of an international emergency medicine intervention in Tuscany.
To measure the effectiveness of a 9-month emergency medicine 'train the trainers' program in Tuscany, Italy. ⋯ When measured by written examinations, oral examinations and physician self-assessment, a train the trainers program, designed as part of an international emergency medicine collaboration, was efficacious.
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Randomized Controlled Trial Multicenter Study Comparative Study
Predictive validity comparison of two five-level triage acuity scales.
Each of the two most commonly used five-level triage tools in North America, the Emergency Severity Index and the Canadian Triage and Acuity Scale have been used as a measure of emergency department resource utilization in addition to acuity. In both cases, it is believed that patients triaged as having a higher level of acuity require a greater number of emergency department resources. We compared the ability of each tool to predict the emergency department resources for each emergency department visit and associated hospital admission and in-hospital mortality rates. ⋯ No statistically significant difference was observed in the ability of Emergency Severity Index v. 3 and Canadian Triage and Acuity Scale to predict emergency department resource utilization or immediate patient outcomes. This ability is, at best, only moderate indicating that other, more accurate tools than measures of triage acuity are required for this purpose.
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To evaluate the reasons behind the demographic characteristics of patients presented to emergency departments. ⋯ Demographical trends show that emergency department visits by elderly patients would increase in time. So, in Turkey, emergency department staff should be trained to provide for the special needs of this population in emergency departments.
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Multicenter Study
Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients.
The impact of prehospital care after the return of spontaneous circulation in out-of-hospital cardiac arrest patients is not known. This study describes adherence to the resuscitation guidelines, factors associated with poor adherence and possible impact of prehospital postresuscitation care on the outcome of out-of-hospital cardiac arrest. ⋯ Less than 50% of out-of-hospital cardiac arrest patients received prehospital postresuscitation care compatible with the current guidelines. Markers of poor prognosis were associated with unsatisfactory care, which in turn was more frequent among the patients who did not survive to hospital discharge. The importance of the guidelines should be highlighted in the future.
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Multicenter Study
Low molecular weight heparin self-injection training: assessment of feasibility, tolerance and economic analysis in emergency departments.
The purpose of this study was to assess low molecular weight heparin auto-injection skills of self-supporting patients, taught by a nurse through a rapid demonstration in an emergency department. ⋯ It seems possible to extend the practice of self-injection to other types of injections prescribed after discharge from the emergency department, such as preventive low molecular weight heparin for surgical or medical purposes and curative ambulatory low molecular weight heparin treatment for deep vein thrombosis.