Emergency medicine journal : EMJ
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Multicenter Study
Predictive accuracy of triage nurses evaluation in risk stratification of syncope in the emergency department.
Syncope is a common clinical problem that accounts for 1-3% of all emergency department (ED) visits. Its prognosis is extremely variable with a 1-year mortality that may reach 30%. There are no available data about the accuracy of nursing triage in identifying high-risk syncope. The aim of our study was to evaluate the predictive accuracy of nursing triage in identifying high-risk syncope. ⋯ Nursing triage was characterised by a low predictive accuracy in identifying high-risk individuals.
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Sudden cardiac arrest (SCA) on the field of play remains one of the most tragic and challenging events for a team physician. Even with robust regular preparticipation cardiac screening we cannot prevent all cases of SCA. Ability to recognise imminent cardiac arrest occurring on the field of play remains an important step in managing this condition without delay. ⋯ When on the field of play, in the absence of head injury, athletes displaying bowing and/or kneeling positions followed by collapse should be assumed to have a life-threatening cardiac event. Final position of 'prostration' was adopted in over half of cardiogenic collapses. A sports medicine professional should bear this in mind and target his/her assessment and treatment accordingly. When attending such casualties, a defibrillator must be taken to the collapsed player.
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Emergency departments are high-risk structures. The objective was to analyse the functioning of an experience feedback committee (EFC), a security management tool for the analysis of incidents in a medical department. ⋯ The staff took part actively in the EFC. Following the analysis of incidents, the EFC was able to set up actions at the departmental level. Thus, an EFC seems to be an appropriate security management tool for an emergency department.
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While the benefits of regional analgesia (RA) for preoperative pain relief in hip fracture (HF) in elderly patients are well recognised, this service is yet to be established in many UK emergency departments (EDs). We set out to discover how widely RA is adopted in the UK EDs. ⋯ RA for HFs is not widely used in UK EDs, proving that there is room for improvement .The finding that RA blocks are performed by the ED medical staff in 84% of the responding EDs practising RA was reassuring for developing the service in our hospital. FICB should be considered as an alternative to parenteral analgesia in adult patients with HF.