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European Journal of Emergency Medicine
Journal Prestige (SJR): 0.597  Citation Impact (citeScore): 1 Number of Followers: 25  Hybrid journal (It can contain Open Access articles)ISSN (Print) 0969-9546 - ISSN (Online) 1473-5695 Published by LWW Wolters Kluwer  [330 journals]
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- An expresso with EUSEM
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Authors: Leach; Robert
Abstract: No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Overview of quality and safety in emergency medicine
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Authors: Bellou; Abdelouahab; Heyworth, John; ; on behalf of the European Society for Emergency Medicine Working Group on Quality Safety in Emergency Medicine (EWQSEM
Abstract: No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Telemedicine for the management of patients calling an Emergency Medical
Communication Center for dyspnea: a before-after study-
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Authors: Marjanovic; Nicolas; Autin, Mathieu; Violeau, Mathieu; Mimoz, Olivier; Guenezan, Jérémy
Abstract:
No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Diagnosis of dilated cardiomyopathy with point-of-care ultrasound in
patients with unexplained shortness of breath: a case series-
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Authors: Le Bastard; Quentin; Javaudin, François; Montassier, Emmanuel; Pes, Philippe; Le Conte, Philippe
Abstract: No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Standard vs. modified vestibular/ocular motor screening for emergency
department prediction of symptom persistence 1 week after minor head
injury-
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Authors: Thomas; Caroline E.; Pathan, Sameer A.; Bhutta, Zain A.; Qureshi, Isma; Thomas, Stephen H.
Abstract:
No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Identifying needs of older patients at the emergency department
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Authors: García-Martínez; Ana; Artajona, Lourdes; Aguiló, Sira
Abstract: No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Response to ‘Identifying needs of older patients at the emergency
department’-
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Authors: Karamercan; Mehmet A.; Dündar, Defne Z.
Abstract: No abstract available
PubDate: Tue, 24 Oct 2023 00:00:00 GMT-
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- Research methods in quality and safety in emergency medicine
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Authors: Hachimi-Idrissi; Said; Bergs, Jochen; Tsilimingras, Dionyssios; on behalf of the European Society for Emergency Medicine Working Group on Quality Safety in Emergency Medicine (EWQSEM
Abstract: No abstract available
PubDate: Fri, 06 Oct 2023 00:00:00 GMT-
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- Status of the specialty Emergency Medicine in Europe
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Authors: Behringer; Wilhelm; Brown, Ruth
Abstract:
No abstract available
PubDate: Thu, 21 Sep 2023 00:00:00 GMT-
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- Global emergency care: a quality and safety perspective
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Authors: Cattermole; Giles N.; Kumar, Vijaya Arun; Walravens, Stig; on behalf of the European Society for Emergency Medicine Working Group on Quality Safety in Emergency Medicine (EWQSEM
Abstract: No abstract available
PubDate: Wed, 20 Sep 2023 00:00:00 GMT-
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- How should we train emergency physicians for quality and safety
activities'-
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Authors: Brown; Ruth; Kurland, Lisa; Lojo Rial, Carlos; ; on behalf of the European Society for Emergency Medicine Working Group on Quality Safety in Emergency Medicine (EWQSEM
Abstract: No abstract available
PubDate: Wed, 20 Sep 2023 00:00:00 GMT-
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- Diagnosis and practical management of digoxin toxicity: a narrative review
and consensus-
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Authors: Andrews; Paul; Anseeuw, Kurt; Kotecha, Dipak; Lapostolle, Frédéric; Thanacoody, Ruben
Abstract:
There are currently no universally accepted guidelines for the management of digoxin toxicity. In the absence of clinical practice guidelines, a set of consensus recommendations for management of digoxin toxicity in the clinical setting were developed through a modified Delphi approach. The recommendations highlight the importance of early recognition of signs of potentially life-threatening toxicity that requires immediate treatment with digoxin-specific antibodies. The consensus identifies a straightforward approach to dosing immune antibody fragments according to the presence or absence of signs of life-threatening toxicity. Supportive measures and management of specific signs of toxicity are also covered.
PubDate: Fri, 25 Aug 2023 00:00:00 GMT-
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- Immigration bias among medical students: a randomized controlled trial
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Authors: Grafeneder; Jürgen; Baewert, Andjela; Katz, Henri; Holzinger, Anita; Niederdoeckl, Jan; Roth, Dominik
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Background and importance Racial bias is found in both physicians and medical students. Immigrants in many parts of the world face challenges similar to racial minorities. Identification of immigrants might however be more subtle than identification by race, and currently, no data are available on a possible bias against the large minority group of migrants in Europe.Design Randomized control trial.Settings and participants Second-year medical students were randomized into four groups to watch a video of either a male or female patient with pain, with or without immigrant status.Intervention Students were asked whether they would administer pain medication (primary outcome).Outcome measures and analysis Immigrant status, patient’s gender, student’s gender, age, and language skills were covariates in a logistic regression model. Secondary outcomes included pain medication potency and the student’s rating of the patient’s pain intensity.Main results We recruited 607 students [337 females (56%), 387 (64%) between 18 and 22 years old]. Analgesia was administered in 95% (n = 576). Immigrant status was not associated with the probability of receiving pain medication [95 vs. 95%, odds ratio (OR) 0.81, 95% confidence interval (CI) 0.39–1.70, P = 0.58]. Immigrants received high-potency analgesia less often (26 vs. 33%, OR 0.69, 95% CI 0.50–0.96, P = 0.03). Female students administered pain medication more frequently (96 vs. 93%, OR 2.29, 95% CI 1.05–5.02, P = 0.04), and rated the patients’ pain higher (mean numeric rating scale 7.7, SD 0.9 vs. 7.4, SD 1.0, OR 1.36, 95% CI 1.16–1.60, P
PubDate: Fri, 25 Aug 2023 00:00:00 GMT-
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- Using emergency department triage for machine learning-based admission and
mortality prediction-
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Authors: Tschoellitsch; Thomas; Seidl, Philipp; Böck, Carl; Maletzky, Alexander; Moser, Philipp; Thumfart, Stefan; Giretzlehner, Michael; Hochreiter, Sepp; Meier, Jens
Abstract:
Aims Patient admission is a decision relying on sparsely available data. This study aims to provide prediction models for discharge versus admission for ward observation or intensive care, and 30 day-mortality for patients triaged with the Manchester Triage System.Methods This is a single-centre, observational, retrospective cohort study from data within ten minutes of patient presentation at the interdisciplinary emergency department of the Kepler University Hospital, Linz, Austria. We trained machine learning models including Random Forests and Neural Networks individually to predict discharge versus ward observation or intensive care admission, and 30 day-mortality. For analysis of the features’ relevance, we used permutation feature importance.Results A total of 58323 adult patients between 1 December 2015 and 31 August 2020 were included. Neural Networks and Random Forests predicted admission to ward observation with an AUC-ROC of 0.842 ± 0.00 with the most important features being age and chief complaint. For admission to intensive care, the models had an AUC-ROC of 0.819 ± 0.002 with the most important features being the Manchester Triage category and heart rate, and for the outcome 30 day-mortality an AUC-ROC of 0.925 ± 0.001. The most important features for the prediction of 30 day-mortality were age and general ward admission.Conclusion Machine learning can provide prediction on discharge versus admission to general wards and intensive care and inform about risk on 30 day-mortality for patients in the emergency department.
PubDate: Mon, 14 Aug 2023 00:00:00 GMT-
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- Predictive factors for early requirement of respiratory support through
phone call to Emergency Medical Call Centre for dyspnoea: a retrospective
cohort study-
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Authors: Balen; Frederic; Lamy, Sebastien; Fraisse, Sarah; Trinari, Julie; Bounes, Vincent; Dubucs, Xavier; Charpentier, Sandrine
Abstract:
Background 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.Objective To identify predictive factors regarding the need for early respiratory support in patients who call the Emergency Medical Call Centre for dyspnoea.Design, settings and participants This retrospective cohort study carried out in the Emergency Medical Call Centre of the University Hospital of Toulouse from 1 July to 31 December 2019. Patients over the age of 15 who call the Emergency Medical Call Centre regarding dyspnoea and who were registered at the University Hospital or died before admission were included in our study.Outcome measure and analysis The primary end-point was early requirement of respiratory support [including high-flow oxygen, non-invasive ventilation (NIV) or mechanical ventilation after intubation] that was initiated by the physicians staffed ambulance before admission to the hospital or within 3 h after being admitted. Associations with patients’ characteristics identified during Emergency Medical Call Centre calls were assessed with a backward stepwise logistic regression after multiple imputations for missing values.Main results During the 6-month inclusion period, 1425 patients called the Emergency Medical Call Centre for respiratory issues. After excluding 38 calls, 1387 were analyzed, including 208 (15%) patients requiring respiratory support. The most frequent respiratory support used was NIV (75%). Six independent predictive factors of requirement of respiratory support were identified: chronic β2-mimetics medication [odds ratio (OR) = 2.35, 95% confidence interval (CI) 1.61–3.44], polypnea (OR = 5.78, 95% CI 2.74–12.22), altered ability to speak (OR = 2.35, 95% CI 1.55–3.55), cyanosis (OR = 2.79, 95% CI 1.81–4.32), sweats (OR = 1.93, 95% CI 1.25–3) and altered consciousness (OR = 1.8, 95% CI 1.1–3.08).Conclusion During first calls for dyspnoea, six predictive factors are independently associated with the risk of early requirement of respiratory support.
PubDate: Wed, 09 Aug 2023 00:00:00 GMT-
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- MEESSI-AHF score to estimate short-term prognosis of acute heart failure
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Authors: Oberlin; Mathieu; Buis, Guillaume; Alamé, Karine; Martinez, Mikaël; Bitard, Marie Paule; Berard, Lise; Losset, Xavier; Balen, Frederic; Lehodey, Bruno; Taheri, Omide; Delannoy, Quentin; Kepka, Sabrina; Tran, Duc-Minh; Bilbault, Pascal; Godet, Julien; Le Borgne, Pierrick
Abstract:
Background The assessment of acute heart failure (AHF) prognosis is primordial in emergency setting. Although AHF management is exhaustively codified using mortality predictors, there is currently no recommended scoring system for assessing prognosis. The European Society of Cardiology (ESC) recommends a comprehensive assessment of global AHF prognosis, considering in-hospital mortality, early rehospitalization rates and the length of hospital stay.Objective We aimed to prospectively evaluate the performance of the Multiple Estimation of risk based on the Emergency department Spanish Score In patients with AHF (MEESSI-AHF) score in estimating short prognosis according to the ESC guidelines.Design, settings and patients A multicenter study was conducted between November 2020, and June 2021. Adult patients who presented to eleven French hospitals for AHF were prospectively included.Outcome measures and analysis According to MEESSI-AHF score, patients were stratified in four categories corresponding to mortality risk: low-, intermediate-, high- and very high-risk groups. The primary outcome was the number of days alive and out of the hospital during the 30-day period following admission to the Emergency Department (ED).Results In total, 390 patients were included. The number of days alive and out of the hospital decreased significatively with increasing MEESSI-AHF risk groups, ranging from 21.2 days (20.3–22.3 days) for the low-risk, 20 days (19.3–20.5 days) for intermediate risk,18.6 days (17.6–19.6 days) for the high-risk and 17.9 days (16.9–18.9 days) very high-risk category.Conclusion Among patients admitted to ED for an episode of AHF, the MEESSI-AHF score estimates with good performance the number of days alive and out of the hospital.
PubDate: Mon, 31 Jul 2023 00:00:00 GMT-
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- Performance of the Fresno-Quebec Rule in identifying patients with
concomitant fractures not requiring a radiograph before shoulder
dislocation reduction: a multicenter retrospective cohort study-
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Authors: Benhamed; Axel; Bonnet, Margot; Miossec, Auriane; Mercier, Eric; Hernu, Romain; Douplat, Marion; Gorincour, Guillaume; L’Huillier, Romain; Abensur Vuillaume, Laure; Tazarourte, Karim
Abstract:
Background and importance Although shoulder dislocation diagnosis is often solely based on clinical examination, physicians may order a radiograph to rule out a concomitant shoulder fracture before performing reduction. The Fresno-Québec decision rule aims to identify patients requiring a radiograph before reduction to avoid unnecessary systematic imaging. However, this novel approach needs further validation.Objective To evaluate the performance of the Fresno-Québec rule in identifying patients who do not require a prereduction radiograph and assess the variables associated with a clinically significant fracture.Design, settings, and participants A multicenter, retrospective cohort study from 2015 to 2021. Data were extracted from three ED university-affiliated tertiary-care centers. Patients aged ≥18 years with a final diagnosis of anterior glenohumeral dislocation were included.Outcomes measure and analysis Accuracy metrics [sensitivity (Se), specificity (Sp), positive (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR)] of the Fresno-Québec rule were measured. Multivariable logistic regression model was used to identify variables associated with the presence of a concomitant clinically significant fracture.Main results A total of 2129 patients were included, among whom 9.7% had a concomitant fracture. The performance metrics of the Fresno-Québec rule were as follows: Se 0.96 95% confidence interval (0.92–0.98), Sp 0.36 (0.34–0.38), PPV 0.14 (0.12–0.16), NPV 0.99 (0.98–0.99), PLR 1.49 (1.42–1.55) and NLR 0.12 (0.06–0.23). A total of 678 radiographs could have been avoided, corresponding to a reduction of 35.2%. Age ≥40 years, first dislocation episode [odds ratio (OR) = 3.18 (1.95–5.38); P
PubDate: Mon, 31 Jul 2023 00:00:00 GMT-
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- Exposure to organophosphorus compounds: best practice in managing timely,
effective emergency responses-
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Authors: Dorandeu; Frédéric; Singer, Christopher; Chatfield, Steven; Chilcott, Robert P.; Hall, Jonathan
Abstract: Increasing indications, reports and studies demonstrate that threats from the deliberate use of chemical weapons remain high and are evolving. One of the deadliest classes of chemical weapons are the organophosphorus nerve agents. It is now clear that both state and non-state actors have the ability to deploy and use these types of weapons against individuals and the wider civilian population posing a real and significant threat. The objective of this article is to provide an overview of the issues impacting on a timely critical response to the accidental or deliberate release of Organophosphorus Nerve Agents in order to enhance the understanding of their effects and provide guidance on how first responders might better treat themselves or victims of exposure through a discussion of available evidence and best practices for rapid skin decontamination. The article also examines use of the current nomenclature of ‘wet’ and ‘dry’ to describe different forms of decontamination. One of the key conclusions of this article is that adequate preparedness is essential to ensuring that responders are trained to understand the threat posed by Organophosphorus Nerve Agents as well as how to approach a contaminated environment. A key aspect to achieving this will be to ensure that generic medical countermeasures are forward-deployed and available, preferably within minutes of a contamination and that first responders know how to use them.
PubDate: Fri, 14 Jul 2023 00:00:00 GMT-
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