Emergency medicine journal : EMJ
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ILCOR recommend the use of therapeutic hypothermia (32-34 degrees C) for 12-24 h in unconscious adult patients with spontaneous circulation after cardiac arrest with a VF rhythm. Among various methods of inducing hypothermia, the rapid infusion of ice-cold intravenous fluid has been used. ⋯ As induced hypothermia should be started as soon as possible in eligible patients, crystalloids should be stored in a refrigerator.
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Severe pain is a common presenting symptom for emergency patients. One major challenge in the management of severe pain is the objective measurement of pain. Due to the subjective nature of pain, it can be very difficult for clinicians to quantify pain intensity and measure the qualitative features of the pain experience. ⋯ This paper reviews the characteristics required of a prehospital acute pain measure and appraises the relative utility of a number of currently used pain measures. At present, the verbal numerical rating scale appears the most appropriate pain measure to administer in the prehospital setting for adult patients as it is practical and valid. Either the Oucher scale or the faces pain scale is suitable for prehospital care providers to assess pain in children.
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Multicenter Study Comparative Study
Comparing methods of detecting alcohol-related emergency department presentations.
To assess the strengths and limitations of different methods for detecting alcohol-related emergency department (ED) presentations and to compare the characteristics of patients who present to the ED with an alcohol-related presentation with ED patients who are found to be risky drinkers by a questionnaire. ⋯ Not all patients with an alcohol-related ED presentation usually drink at risky levels, nor do all risky drinkers present to the ED for an alcohol-related reason. The use of routinely recorded nursing triage text detects over a third of alcohol-related ED presentations with no additional burden on busy clinicians. As these data are potentially readily accessible, further research is needed to evaluate their validity for the detection of alcohol-related ED presentations.
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Multicenter Study
Can undergraduate paramedic students accurately identify lung sounds?
The accurate identification of lung sounds during chest auscultation is a skill commonly used by healthcare clinicians, including paramedics, when assessing a patient's respiratory status. It is a necessary skill as it enables confirmation of a patient's respiratory condition and guides the paramedic to a provisional diagnosis and the implementation of appropriate management. The object of this study was to identify if undergraduate paramedic students from two Australian universities were able to interpret a variety of lung sounds accurately. ⋯ In this study undergraduate paramedic students from two Australian universities were found to be inaccurate at interpreting a variety of common lung sounds. The study has highlighted that a greater emphasis needs to be given to lung sound interpretation in undergraduate paramedic education programmes.
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Multicenter Study Comparative Study
Observer agreement of the Manchester Triage System and the Emergency Severity Index: a simulation study.
To compare inter and intra-observer agreement of the Manchester Triage System (MTS) and the Emergency Severity Index (ESI). ⋯ Using paper-based clinical scenarios, MTS was found to have a greater inter and intra-observer agreement than ESI.