Emergency medicine journal : EMJ
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Comparative Study
Epidemiology of prehospital pain: an opportunity for improvement.
This retrospective, electronic patient care record review examined a consecutive sample of patients presenting with pain to the metropolitan region of Ambulance Victoria over a period of 12 months in 2008. The majority of patients did not achieve clinically significant pain reduction, but did achieve some pain relief while in ambulance care. Those with the most severe pain had pain reduction that was clinically significant. Further research is needed to provide optimal pain relief in the prehospital setting.
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Comparative Study
Barriers to incident notification in a regional prehospital setting.
The identification and monitoring of critical incidents or adverse events and error reporting is a relatively new area of study in the prehospital setting. In 2005, we commenced a prospective descriptive study of the implementation of a Critical Incident Monitoring process in a rural/regional pre-hospital setting. The objective of the project was to describe the nature and incidence of errors detected in the management of prehospital trauma with the ultimate aim of identifying processes to reduce or mitigate such incidents. This paper describes the barriers to reporting critical incidents identified during the 3-year study. ⋯ There are numerous barriers to reporting critical incidents. One of the key approaches which may alleviate many of the barriers to reporting is shifting to a systems based focus rather than an individual 'shame and blame' approach. The underlying barriers lie in the culture of the profession, and appear consistent across other health care disciplines.
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Randomized Controlled Trial Multicenter Study Comparative Study
Health utility and survival after hospital admission with acute cardiogenic pulmonary oedema.
The aim of this study was to measure health utility and survival in patients with acute cardiogenic pulmonary oedema (ACPO), identify predictors of outcome and determine the effect of initial treatment with non-invasive ventilation (NIV) upon outcomes. ⋯ Patients with ACPO have high mortality and reduced health utility. Initial treatment with CPAP or NIPPV does not alter subsequent survival or health utility.