Emergency medicine journal : EMJ
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The Pulmonary Embolism Severity Index (PESI) and the simplified PESI (sPESI) are validated scores for mortality prediction in patients with pulmonary embolism (PE). National Early Warning Score (NEWS) is a general prognostic risk score for multiple clinical settings. We investigated whether the NEWS had a comparable performance with the PESI and sPESI, for predicting intensive care unit (ICU) admission and death in patients with acute PE. ⋯ In comparison with PESI and sPESI, NEWS adequately predicted 7-day ICU admission as well as 30-day mortality, supporting its potential relevance for clinical practice.
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Observational Study
Predefibrillation end-tidal CO2 and defibrillation success in out-of-hospital cardiac arrest: an observational cohort study.
Predefibrillation end-tidal CO2 (ETCO2) may predict defibrillation success and could guide defibrillation timing in ventricular fibrillation (VF) cardiac arrest. This relationship has only been studied using advanced airways. Our aim was to evaluate this relationship using both basic (bag-valve-mask (BVM)) and advanced airways (supraglottic airways and endotracheal tubes). ⋯ Predefibrillation ETCO2 measurement is not associated with VF termination or ROSC when basic and advanced airways are included in the analysis. The role of predefibrillation ETCO2 requires careful consideration of the type of airway used during resuscitation.
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Data on the safety of non-transport decisions for paediatric patients attended by Emergency Medical Services (EMS) are lacking. We describe the characteristics and outcomes of paediatric non-transported patients in Victoria, Australia. ⋯ Adverse events were rare among paramedic-initiated non-transport cases. Vital sign derangements and attendance by paramedics with higher prior exposure to non-transports were associated with poorer outcomes and may be used to improve safety.