Emergency medicine journal : EMJ
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To evaluate whether single-channel electroencephalography (EEG) recording can be conducted in the out-of-hospital setting and whether it can be used to record electrographic signs of convulsive epileptic seizures. ⋯ Single-channel EEG can be performed outside the hospital and yields useful recordings in most patients with acceptable rates of artefact. The diagnosis of generalised convulsive epileptic seizures by offline analysis of out-of-hospital EEG showed a high sensitivity and specificity when compared with the clinical diagnosis.
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Most patients involved in motor vehicle crashes (MVCs) are not seriously injured. However, dispatch protocols require an ambulance be sent with lights and sirens (L&S) to the vast majority of MVCs. L&S have been shown to reduce response times minimally. The rate of injuries among prehospital workers is nearly 15 times higher among ambulances operating with L&S than those without. ⋯ A simple three-step dispatch rule for MVCs can safely reduce L&S responses by one-third, as judged by need for transport to a trauma centre or use of trauma centre resources. Prospective validation is needed.
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Self-instruction with a DVD and a simple personal manikin is an effective alternative to traditional basic life support (BLS) courses. Objective To evaluate the effect of distributing DVD training kits to untrained laypersons. BLS skills were compared according to 2005 guidelines for resuscitation after 3.5 months with those obtained in untrained laypersons who completed the same course with instructor facilitation. ⋯ Since no significant difference in total BLS score was found after 3.5 months between untrained laypersons who either completed a DVD-based BLS course in groups with instructor facilitation or received the same DVD training kit without instruction, the latter seems more efficient.
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Nursing is a highly stressful occupation and occupational stress is much greater among nurses who work within emergency departments. However, few studies in China focusing on this problem are available. ⋯ The factors role overload, role boundary and role insufficiency had the highest association with occupational stress. Improving work conditions and providing health education and an occupational training programme might help to reduce occupational stress among Chinese female emergency nurses.
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Benzodiazepine (BZD) overdose (OD) continues to cause significant morbidity and mortality in the UK. Flumazenil is an effective antidote but there is a risk of seizures, particularly in those who have co-ingested tricyclic antidepressants. A study was undertaken to examine the frequency of use, safety and efficacy of flumazenil in the management of BZD OD in the UK. ⋯ Flumazenil is used infrequently in the management of BZD OD in the UK. It was effective and associated with a low incidence of seizure. These results compare favourably with the results of published randomised controlled trials and cohort studies, although previous studies have not reported the use of flumazenil in such a high-risk population. This study should inform the continuing review of national guidance on flumazenil therapy.