Emergency medicine journal : EMJ
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Multicenter Study
Traumatic lacerations: what are the risks for infection and has the 'golden period' of laceration care disappeared?
To determine risk factors associated with infection and traumatic lacerations and to see if a relationship exists between infection and time to wound closure after injury. ⋯ Diabetes, wound contamination, length greater than 5 cm and location on the lower extremity are important risk factors for wound infection. Time from injury to wound closure is not as important as previously thought. Improvements in irrigation and decontamination over the past 30 years may have led to this change in outcome.
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Multicenter Study
The impact of consultation on length of stay in tertiary care emergency departments.
Consultations in the emergency department (ED) are infrequently studied. This study quantifies the contribution of consultations to ED length of stay (LOS) and examines patient and consultation characteristics associated with prolonged ED LOS. ⋯ Consultation decision time contributes significantly to ED LOS. Further efforts are needed to validate these results in other ED settings and improve this aspect of ED throughput.
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Multicenter Study
Violence in the emergency department: a multicentre survey of nurses' perceptions in Nigeria.
Emergency department (ED) violence is common and widespread. ED staff receive both verbal and physical abuse, with ED nurses bearing the brunt of this violence. The violence is becoming increasingly common and lethal and many institutions are still improperly prepared to deal with it. ⋯ There is a need to make the EDs safer for all users. This can be achieved by a deliberate management policy of 'zero' tolerance to workplace violence, effective reporting systems, adequate security and staff training on prevention of violence.
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Multicenter Study Clinical Trial
Mid-regional pro-adrenomedullin improves disposition strategies for patients with acute dyspnoea: results from the BACH trial.
To assess the value of mid-regional pro-adrenomedullin (MR-proADM) in guiding patient disposition from the emergency department (ED), as one of the key factors of hospital resource utilisation, in undifferentiated patients with acute dyspnoea. ⋯ MR-proADM has the potential to guide initial disposition of undifferentiated ED patients with acute dyspnoea and might therefore be helpful to improve resource utilisation and patient care.
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Multicenter Study
Aspirin administration by emergency medical dispatchers using a protocol-driven aspirin diagnostic and instruction tool.
The American College of Cardiology and the American Heart Association recommend early aspirin administration to patients with symptoms of acute coronary syndrome (ACS)/acute myocardial infarction (AMI). The primary objective of this study was to determine if Emergency Medical Dispatchers (EMD) can provide chest pain/heart attack patients with standardised instructions effectively, using an aspirin diagnostic and instruction tool (ADxT) within the Medical Priority Dispatch System (MPDS) before arrival of an emergency response crew. ⋯ EMDs, using a standardised protocol, can enable early aspirin therapy to treat potential ACS/AMI prior to responders' arrival. Further research is required to assess reasons for not using the protocol, and the significance of the various associations discovered.