Emergency medicine journal : EMJ
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A shortcut review was carried out to establish whether routine use of bispectral index monitoring in emergency department conscious sedation was effective in improving patient safety. Thirteen unique papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. It is concluded that there is currently insufficient evidence to support the routine use of bispectral index monitoring during conscious sedation and further studies are needed to investigate its exact benefits.
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To understand whether aviation-derived human factors training is acceptable and useful to healthcare professionals. To understand whether and how healthcare professionals have been able to implement human factors approaches to patient safety in their own area of clinical practice. ⋯ In order to successfully apply human factors approaches in hospital, careful consideration needs to be given to the local context and informal culture of clinical practice.
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It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. ⋯ This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access.
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Observational Study
Prevalence of nosocomial pathogens in German ambulances: the SEKURE study.
The increasing prevalence of multidrug resistant bacteria is a problem in the inpatient care setting, and in the emergency care system. The aim of this observational, cross-sectional study was to evaluate the prevalence of pathogens on well-defined surfaces in German ambulances that have been designated as 'ready for service'. ⋯ In accordance with previous studies, disinfection and cleaning of areas with direct contact to patients or staff seem to be the most challenging. This should also be reflected in disinfection guidelines and the related continuing education.
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Observational Study
Diagnostic accuracy of lateral neck radiography in ruling out supraglottitis: a prospective observational study.
To assess the diagnostic accuracy of lateral neck radiographs (LNR) for acute supraglottitis in adults. ⋯ LNR showed only moderate sensitivity and specificity for supraglottitis and would miss some cases of supraglottitis if the pre-test probability is high. LNR was very sensitive for grade 3 or higher supraglottitis, but would miss milder cases.