Articles: emergency-medicine.
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Eur J Trauma Emerg Surg · Dec 2023
Meta AnalysisSurgical versus non-surgical treatment of flail chest: a meta-analysis of randomized controlled trials.
Conflicting evidence exists on the choice of surgical or non-surgical treatment of flail chest injuries. We aimed to perform a meta-analysis comparing outcomes in patients presenting flail chest undergoing surgical or non-surgical treatment. ⋯ Our results suggest that surgical treatment is advantageous compared to non-surgical treatment for patients with flail chest secondary to rib fractures.
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Eur J Trauma Emerg Surg · Dec 2023
Multicenter StudyInfluence of residency discipline and seniority on traumatic musculoskeletal radiographs interpretation accuracy: a multicenter study.
Imaging studies are a significant and integral part of the initial assessment of patients admitted to the emergency department. Developing imaging diagnostic abilities early in residency is of paramount importance. The purpose of this study was to evaluate and compare diagnosis accuracy of common musculoskeletal X-rays (XR) between residency disciplines and seniority. ⋯ Orthopedic residents presented higher diagnosis accuracy of MSK imaging compared to EM and radiology residents. Seniority had a positive effect on diagnosis accuracy. The development of an educational program on MSK XR is necessary to enhance the competency of physicians in their daily practice.
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Atrial fibrillation (AF) may lead to stroke, heart failure, and death. When AF occurs in the context of a rapid ventricular rate/response (RVR), this can lead to complications, including hypoperfusion and cardiac ischemia. Emergency physicians play a key role in the diagnosis and management of this dysrhythmia. ⋯ An understanding of the recent updates in the literature concerning AF with RVR can assist emergency clinicians in the care of these patients.
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Family presence during resuscitation is a growing topic in the field of prehospital emergency medicine. Emergency medicine service (EMS) providers interact with the relatives of acutely critically ill patients daily. Previous studies have found varying preferences towards family presence during resuscitation. Some EMS providers experience family presence affects patient treatment. The study aimed to gain insight into how EMS providers experience relatives of critically ill patients influence patient treatment. ⋯ Our study illustrates how EMS providers experience that treatment is influenced by relatives of acutely critically ill patients in the prehospital emergency medicine setting. Relatives can help or challenge treatment, and also influence EMS providers' clinical decision-making. Our findings can guide those working in prehospital emergency medicine towards utilising relatives of critically ill patients and increasing our understanding of how relatives can influence EMS providers' treatment and their clinical decision-making. Future studies should seek to quantify relatives' effect on treatment and investigate the clinical and ethical aspects of futile resuscitation.
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Acute dyspnoea is a common symptom in Emergency Medicine, and severity assessment is difficult during the first time the patient calls the Emergency Medical Call Centre. ⋯ During first calls for dyspnoea, six predictive factors are independently associated with the risk of early requirement of respiratory support.