Emergency medicine journal : EMJ
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To determine the efficacy of the abbreviated Mortality in Emergency Department Sepsis (MEDS) score, the Modified Early Warning (MEW) score and near-patient-test (NPT) lactate levels in predicting 28-day mortality in adult emergency department (ED) patients with sepsis. ⋯ These results demonstrate the efficacy of the abbreviated MEDS score, the MEW score and NPT venous lactate levels in predicting 28-day mortality in ED patients with sepsis. The abbreviated MEDS score was found to be the best performing risk assessment model which, with prospective validation, may aid early clinical decision-making in ED patients with sepsis and might affect the outcome from sepsis.
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Multicenter Study
The health behaviour and clinical characteristics of ambulance users with acute asthma.
This study sought to determine if ambulance service users differ in their health behaviours to "walk-in" patients attending an emergency department (ED) with acute asthma. ⋯ Ambulance users with acute asthma are more likely to be older, married and less educated. There is no evidence that this group is less responsible in managing their health; however, fewer ambulance users attended their follow-up appointment and the implication for ongoing care requires further investigation.
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Multicenter Study
Coma and impaired consciousness in the emergency room: characteristics of poisoning versus other causes.
Unconscious patients represent a diagnostic challenge in the emergency room (ER), but studies on their characteristics are limited. The aim of this study was to investigate the frequency, characteristics and prognosis of different coma aetiologies with special focus on poisoning. ⋯ Poisoning was the most common cause of coma and young age was a strong predictor of this condition. The prognosis was favourable among poisoned patients but poor in the rest of the study population as a group.
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Multicenter Study
Influence of air ambulance doctors on on-scene times, clinical interventions, decision-making and independent paramedic practice.
Critics of air ambulance doctors question their contribution and believe on-scene time is prolonged. Two helicopter emergency medical service (HEMS) models operate in the West Midlands, one with doctors and the other without. A study was undertaken to compare on-scene time, management and decision-making between the two units. ⋯ Appropriately trained HEMS doctors provide advanced management and decision-making. This is without a negative effect on on-scene time, even when performing complex procedures. They are more likely to declare death or discharge patients at the scene, increasing the availability of this limited resource.
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Multicenter Study Comparative Study
Door to relocation time for dislocated hip prosthesis: multicentre comparison of emergency department procedural sedation versus theatre-based general anaesthesia.
Dislocation of a hip prosthesis is a painful event which has an incidence of 4% for primary total hip arthroplasty. Relocation is traditionally performed under general anaesthesia in the operating theatre, but relocation using sedation in the emergency department (ED) has been reported, with a limited success rate of 62%. A study was undertaken to compare door to relocation times for ED sedation and theatre general anaesthesia. ⋯ Reduction of dislocated hip prostheses in the ED saves nearly 6 h compared with theatre-based general anaesthesia and is therefore advocated.