Emergency medicine journal : EMJ
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Early goal-directed therapy (EGDT) has been shown to improve outcome in patients presenting to the emergency department (ED). Uptake of EGDT in EDs in the UK has been slow. ⋯ Full delivery of EGDT by ED staff would require significant consultant support, improved training of juniors and flexibility in the 4 h target. This study suggests that it may be practical for EGDT to be initiated in the ED and that early referral to critical care will remain essential if patients are to receive the full benefit of this intervention.
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Heat stroke is rare and usually occurs in warm conditions. It is often fatal. This paper reports six runners from two road-running events who developed heat stroke despite cool conditions and who improved quickly with immediate treatment.
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Nefopam hydrochloride (Acupan) is a potent non-opioid analgesic widely used for the relief of moderate to severe postoperative pain. The drug is generally well tolerated, but it has a broad spectrum of side effects including tachycardia, sweating, nausea, seizures and hallucinations. ⋯ The case is presented of a previously healthy 19-year-old man who presented to the emergency department in cardiac arrest following intentional nefopam overdose. It is only the fourth reported case of fatal nefopam overdose in the literature.
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To evaluate the effect of standard operating procedures (SOPs) to improve the completion of patient care documentation items on patient care reports (PCRs) in a physician-staffed, 4500-calls-per-year preclinical ground emergency medical service (EMS) base. ⋯ In this EMS base, developing SOPs is an effective tool to improve the quality of PCRs and the rate of completion of documentation items. Check boxes on PCR forms seem to have an important impact as they prompt the initial assessment, treatment and documentation of the actions taken during an EMS call. Consequently, SOPs and check boxes may serve to improve the transition of important information to emergency department staff, and thus contribute to improved patient care.