Emergencias
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Review Meta Analysis
[Usefulness of scoring risk for adverse outcomes in older patients with the Identification of Seniors at Risk scale and the Triage Risk Screening Tool: a meta-analysis].
A considerable proportion of the geriatric population experiences unfavorable outcomes of hospital emergency department care. An assessment of risk for adverse outcomes would facilitate making changes in clinical management by adjusting available resources to needs according to an individual patient's risk. Risk assessment tools are available, but their prognostic precision varies. ⋯ The sensitivity of the ISAR scoring system as a whole ranged between 67% and 99%; specificity fell between 21% and 41%. TRST sensitivity ranged between 52% and 75% and specificity between 39% and 51%. We conclude that the tools currently used to assess risk of adverse outcomes in patients of advanced age attended in hospital emergency departments do not have adequate prognostic precision to be clinically useful.
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The quality of telephone-assisted cardiopulmonary resuscitation (CPR) needs improvement. This study investigates whether a dispatchers' perception is an adequate measure of the actual quality of CPR provided by laypersons. ⋯ The ability of dispatchers to estimate the quality of telephone-assisted CPR is limited. Dispatchers estimates of CPR adequacy needs to be studied further in order to find ways that telephone-assisted CPR might be improved.
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To evaluate the level of agreement between hematologists and emergency medicine physicians regarding the best clinical practices for managing bleeding and anticoagulant reversal. ⋯ The points of consensus were generally in line with clinical practice guidelines, but the Delphi process revealed that there are aspects of the clinical management of bleeding that require unified criteria. The need for specific antidotes for direct-acting oral anticoagulants was emphasized.
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Multicenter Study
[Noninvasive mechanical ventilation in emergency services in Catalonia: the VNICat registry cohort study].
To study how noninvasive ventilation (NIV) is used in prehospital emergency services and hospital emergency departments. To explore associations between NIV use and hospital mortality. ⋯ The use of NIV in prehospital and hospital emergency care follows current evidence-based recommendations and is required more often for AHF than for exacerbated COPD. Hospital mortality is high in this context and is associated with frequent limiting of life support.
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Comparative Study Clinical Trial
[Intervention to reduce the impact of light and noise on sleep in an emergency department observation area].
To study quality of patient rest before and after an intervention to reduce nighttime light and noise in the emergency department observation area of an urban hospital. ⋯ Nighttime rest in emergency department observation areas is affected by ambient light and noise more than by other variables. Reducing light and noise at night can measurably improve patients' rest.