European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Letter Case Reports
Association of aortic valve stenosis and recurrent gastrointestinal bleeding.
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The objective of this study was to identify factors that influence emergency nurses' adherence to an emergency department national protocol (EDNP). A survey of emergency nurses (n=200) and physicians with medical end responsibility on an emergency department (n=103) was carried out. Emergency nurses' self-reported adherence to the EDNP was 38%, 55% of the nurses and 44% of the physicians were aware of the protocol. ⋯ The main influencing factor seems awareness. Other factors related to the individual, the organization and to protocol characteristics. Solely disseminating the EDNP is not enough to get the protocol used in clinical practice.
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Letter Case Reports
A case of acute valproic acid poisoning treated successfully with L-carnitine.
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Spinal epidural hematoma (SEH) is a rare neurosurgical emergency. SEH is characterized by an archetypal clinical presentation including abrupt spinal pain followed more or less rapidly by various degrees of neurological deficit. The diagnosis of SEH, often based on a clinical presumption, represents a clinical challenge. ⋯ We suggest that SEH is a dynamic disease, which occurs in patients with an abnormal vasculature structural degenerative change. The bleeding is probably of multifactorial origin incriminating veins as well as arteries. Therefore, we proposed a classification of SEH, according to the most probable etiology whatever the associated factors, in six groups: spontaneous, secondary, iatrogenic, traumatic, recurrent, and idiopathic SEH.