Articles

High inter-observer agreement of observer-perceived pain assessment in the emergency department

Triage is used to prioritize the patients in the emergency department. The majority of the triage systems include the patients’ pain score to assess their level of acuity by using a combination of patient repo...

Authors: Martin Høhrmann Hangaard, Brian Malling and Christian Backer Mogensen

Ambulance use is not associated with patient acuity after road traffic collisions: a cross-sectional study from Addis Ababa, Ethiopia

Africa accounts for one sixth of global road traffic deaths—most in the pre-hospital setting. Ambulance transport is expensive relative to other modes of pre-hospital transport, but has advantages in time-sens...

Authors: Yonas Abebe, Tolesa Dida, Engida Yisma and David M. Silvestri

Correction to: Systematic reporting to improve the emergency medical response to major incidents: a pilot study

The original article [1] contains an error whereby all authors’ names were mistakenly interchanged. The original article has now been corrected to present the authors’ names correctly.

Authors: Sophie Hardy, Sabina Fattah, Torben Wisborg, Lasse Raatiniemi, Trine Staff and Marius Rehn

Ultrasound-guided identification of the cricothyroid membrane in a patient with a difficult airway: a case report

Surgical cricothyroidotomy is considered to be the last resort for management of the difficult airway. A major point for a successful surgical cricothyroidotomy is to identify the location of the cricothyroid ...

Authors: Hiromu Okano, Kohji Uzawa, Kunitaro Watanabe, Akira Motoyasu, Joho Tokumine, Alan Kawarai Lefor and Tomoko Yorozu

Systematic reporting to improve the emergency medical response to major incidents: a pilot study

Major incidents affect us globally, and are occurring with increasing frequency. There is still no evidence-based standard regarding the best medical emergency response to major incidents. Currently, reports o...

Authors: Sophie Hardy, Sabina Fattah, Torben Wisborg, Lasse Raatiniemi, Trine Staff and Marius Rehn

Management and outcomes of patients presenting with sepsis and septic shock to the emergency department during nursing handover: a retrospective cohort study

Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is chall...

Authors: Sami Alsolamy, Atheer Al-Sabhan, Najla Alassim, Musharaf Sadat, Eman Al Qasim, Hani Tamim and Yaseen M Arabi

An unusual case of infective pneumocephalus: case report of pneumocephalus exacerbated by continuous positive airway pressure

Pneumocephalus, illustrated by air in the cranial vault is relatively infrequent and generally associated with neurosurgery, trauma, meningitis and barotrauma. However cases of spontaneous non-traumatic pneumo...

Authors: Abdus Samad Ansari, Brittany B. Dennis, Dilip Shah and Winfred Baah

Implementing blended learning in emergency airway management training: a randomized controlled trial

While emergency airway management training is conventionally conducted via face-to-face learning (F2FL) workshops, there are inherent cost, time, place and manpower limitations in running such workshops. Blend...

Authors: Madeleine Huei Tze Kho, Keng Sheng Chew, Muhaimin Noor Azhar, Mohd Lotfi Hamzah, Kee Man Chuah, Aida Bustam and Hiang Chuan Chan

A prospective, observational cohort study of patients presenting to an emergency department with acute shoulder trauma: the Manchester emergency shoulder (MESH) project

Fracture and dislocation of the shoulder are usually identifiable through the use of plain radiographs in an emergency department. However, other significant soft tissue injuries can be missed at initial prese...

Authors: Michael J. Callaghan, Janos P. Baombe, Dan Horner, Charles E. Hutchinson, Dilraj Sandher and Simon Carley

Accuracy of acute burns diagnosis made using smartphones and tablets: a questionnaire-based study among medical experts

Remote assistance for burns by medical experts can support nurses and general physicians in emergency care with diagnostic and management advice. Previous studies indicate a high diagnostic accuracy based on i...

Authors: Lisa Blom, Constance Boissin, Nikki Allorto, Lee Wallis, Marie Hasselberg and Lucie Laflamme

The effectiveness of physiologically based early warning or track and trigger systems after triage in adult patients presenting to emergency departments: a systematic review

Changes to physiological parameters precede deterioration of ill patients. Early warning and track and trigger systems (TTS) use routine physiological measurements with pre-specified thresholds to identify det...

Authors: Francesca Wuytack, Pauline Meskell, Aislinn Conway, Fiona McDaid, Nancy Santesso, Fergal G. Hickey, Paddy Gillespie, Adam J. N. Raymakers, Valerie Smith and Declan Devane

Safety and applicability of a pre-stage public access ventilator for trained laypersons: a proof of principle study

Contemporary resuscitation guidelines for basic life support recommend an immediate onset of cardiac compressions in case of cardiac arrest followed by rescue breaths. Effective ventilation is often omitted du...

Authors: Patricia Fuchs, Juliane Obermeier, Svend Kamysek, Martin Degner, Hannes Nierath, Henning Jürß, Hartmut Ewald, Jens Schwarz, Martin Becker and Jochen K. Schubert

Barriers and facilitating factors related to use of early warning score among acute care nurses: a qualitative study

The early warning score (EWS) was developed to identify deteriorating patients early. It is a track-and-trigger system based on vital signs designed to direct appropriate clinical responses based on the seriou...

Authors: John Asger Petersen, Lars S. Rasmussen and Susan Rydahl-Hansen

The effectiveness of prehospital hypertonic saline for hypotensive trauma patients: a systematic review and meta-analysis

The optimal prehospital fluid for the treatment of hypotension is unknown. Hypertonic fluids may increase circulatory volume and mute the pro-inflammatory response of the body to injury and illness. The purpos...

Authors: I. E. Blanchard, A. Ahmad, K. L. Tang, P. E. Ronksley, D. Lorenzetti, G. Lazarenko, E. S. Lang, C. J. Doig and H. T. Stelfox

The association of duration of boarding in the emergency room and the outcome of patients admitted to the intensive care unit

The demand for critical care beds is increasing out of proportion to bed availability. As a result, some critically ill patients are kept in the Emergency Department (ED boarding) awaiting bed availability. Th...

Authors: Saad Al-Qahtani, Abdullah Alsultan, Samir Haddad, Abdulmohsen Alsaawi, Moeed Alshehri, Sami Alsolamy, Afef Felebaman, Hani M. Tamim, Nawfal Aljerian, Abdulaziz Al-Dawood and Yaseen Arabi

Cardiac patients’ perceptions of neighboring patients’ risk: influence on psychological stress in the ED and subsequent posttraumatic stress

As many as 12% of acute coronary syndrome (ACS) patients screen positive for post-traumatic stress disorder (PTSD) symptoms due to their cardiac event, and emergency department (ED) factors such as overcrowdin...

Authors: Beatrice Konrad, David Hiti, Bernard P. Chang, Jessica Retuerto, Jacob Julian and Donald Edmondson

Who breaches the four-hour emergency department wait time target? A retrospective analysis of 374,000 emergency department attendances between 2008 and 2013 at a type 1 emergency department in England

The four-hour target is a key hospital emergency department performance indicator in England and one that drives the physical and organisational design of the ED. Some studies have identified time of presentat...

Authors: Niklas Bobrovitz, Daniel S. Lasserson and Adam D. M. Briggs

Locating helicopter emergency medical service bases to optimise population coverage versus average response time

New South Wales (NSW), Australia has a network of multirole retrieval physician staffed helicopter emergency medical services (HEMS) with seven bases servicing a jurisdiction with population concentrated along...

Authors: Alan A. Garner and Pieter L. van den Berg

Trauma burden in Tanzania: a one-day survey of all district and regional public hospitals

Trauma contributes significantly to the burden of disease and mortality throughout the world, but particularly in developing countries. In Tanzania, there is an enormous research gap on trauma; the limited dat...

Authors: Hendry R. Sawe, Juma A. Mfinanga, Khalid R. Mbaya, Phillip M. Koka, Said S. Kilindimo, Michael S. Runyon, Victor G. Mwafongo, Lee A. Wallis and Teri A. Reynolds

Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study

Pre-hospital emergency care is a vital and integral component of health systems particularly in the resource constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabiliti...

Authors: Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati and Owais Raza

Identifying priorities for quality improvement at an emergency Department in Ghana

Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigat...

Authors: Annelies DeWulf, Elom H. Otchi and Sari Soghoian

Recognition and treatment of severe sepsis in the emergency department: retrospective study in two French teaching hospitals

Sepsis management in the Emergency Department remains a daily challenge. The Surviving Sepsis Campaign (SSC) has released three-hour bundle. The implementation of these bundles in European Emergency Department...

Authors: Philippe Le Conte, Séverin Thibergien, Jean Batiste Obellianne, Emmanuel Montassier, Gilles Potel, Pierre Marie Roy and Eric Batard

Post-traumatic stress disorder and its predictors in emergency medical service personnel: a cross-sectional study from Karachi, Pakistan

Emergency medical service (EMS) personnel who work to provide emergency medical care at the scene and during transportation are exposed to various kinds of stressors and are particularly susceptible to develop...

Authors: Salima Mansoor Kerai, Uzma Rahim Khan, Muhammad Islam, Nargis Asad, Junaid Razzak and Omrana Pasha

Design and rationale of the Procalcitonin Antibiotic Consensus Trial (ProACT), a multicenter randomized trial of procalcitonin antibiotic guidance in lower respiratory tract infection

Overuse of antibiotics is a major public health problem, contributing to growing antibiotic resistance. Procalcitonin has been reported to be commonly elevated in bacterial, but not viral infection. Multiple E...

Authors: David T. Huang, Derek C. Angus, Chung-Chou H. Chang, Yohei Doi, Michael J. Fine, John A. Kellum, Octavia M. Peck-Palmer, Francis Pike, Lisa A. Weissfeld, Jonathan Yabes and Donald M. Yealy

Emergency medical service provider decision-making in out of hospital cardiac arrest: an exploratory study

There are approximately 60,000 out-of-hospital cardiac arrests (OHCA) in the United Kingdom (UK) each year. Within the UK there are well-established clinical practice guidelines that define when resuscitation ...

Authors: J. Brandling, K. Kirby, S. Black, S. Voss and J. Benger

Misuse of emergent healthcare in contemporary Japan

Medical care is obviously an important public service to ensure the health of a nation; however, medical resources are not always used appropriately. ‘Convenience-store consultations’ and inappropriate ambulan...

Authors: Yasuhiro Kadooka, Atsushi Asai, Aya Enzo and Taketoshi Okita

Hypoxia and hypotension in patients intubated by physician staffed helicopter emergency medical services - a prospective observational multi-centre study

The effective treatment of airway compromise in trauma and non-trauma patients is important. Hypoxia and hypotension are predictors of negative patient outcomes and increased mortality, and may be important qu...

Authors: Geir Arne Sunde, Mårten Sandberg, Richard Lyon, Knut Fredriksen, Brian Burns, Karl Ove Hufthammer, Jo Røislien, Akos Soti, Helena Jäntti, David Lockey, Jon-Kenneth Heltne and Stephen J. M. Sollid

Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia

Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients ...

Authors: Mesfin Worku and Eskindir Loha

Development of an education campaign to reduce delays in pre-hospital response to stroke

Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein d...

Authors: Caterina Caminiti, Peter Schulz, Barbara Marcomini, Elisa Iezzi, Silvia Riva, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Enrico Montanari, Mario Baratti and Licia Denti

Reasons for encounter by different levels of urgency in out-of-hours emergency primary health care in Norway: a cross sectional study

Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aime...

Authors: Guttorm Raknes and Steinar Hunskaar

Educational standards for training paramedics in ultrasound: a scoping review

Paramedic-performed out-of-hospital ultrasound is a novel skill that has gained popularity in some services in recent years. In this setting point-of care ultrasound (POCUS) can provide additional information ...

Authors: Ben Meadley, Alexander Olaussen, Ashleigh Delorenzo, Nick Roder, Caroline Martin, Toby St. Clair, Andrew Burns, Emma Stam and Brett Williams

Incidence and outcome of severe ante-partum hemorrhage at the Teaching Hospital Yalgado Ouédraogo in Burkina Faso

Hemorrhage is the main cause of maternal death during pregnancy. This study aims to evaluate incidence and outcomes of Severe Ante Partum Hemorrhage (SAPH) during the third trimester of pregnancy prior to deli...

Authors: Martin Lankoande, Papougnezambo Bonkoungou, Sosthène Ouandaogo, Marcelin Dayamba, Ali Ouedraogo, Francis Veyckmans and Nazinigouba Ouédraogo

Emergency department use and barriers to wellness: a survey of emergency department frequent users

There is no common understanding of how needs of emergency department (ED) frequent users differ from other patients. This study sought to examine how to best serve this population. Examinations of why ED freq...

Authors: Lauren E. Birmingham, Thaddeus Cochran, Jennifer A. Frey, Kirk A. Stiffler and Scott T. Wilber

Management of potentially life-threatening emergencies at 74 primary level hospitals in Mongolia: results of a prospective, observational multicenter study

While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level h...

Authors: Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger and Martin W. Dünser

Developing quality indicators for the care of patients with musculoskeletal injuries in the Emergency Department: study protocol

Musculoskeletal injuries are a common presentation to the Emergency Department (ED). The quality of care provided is important to the patients, clinicians, organisations and purchasers of care. In the context ...

Authors: Kirsten Strudwick, Anthony Bell, Trevor Russell and Melinda Martin-Khan

Estimation of the severity of breathlessness in the emergency department: a dyspnea score

Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients’ rating, can be ambiguous....

Authors: Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány and Gábor Halász

The association of Emergency Department presentations in pregnancy with hospital admissions for postnatal depression (PND): a cohort study based on linked population data

To investigate the impact of presenting to an Emergency Department (ED) during pregnancy on postnatal depression (PND) in women in New South Wales (NSW), Australia.

Authors: Fenglian Xu, Elizabeth A. Sullivan, Roberto Forero and Caroline S. E. Homer

Sepsis recognition in the emergency department – impact on quality of care and outcome?

Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of the...

Authors: Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt and Philipp Kümpers

Prevalence and predictors of intra-abdominal hypertension and compartment syndrome in surgical patients in critical care units at Kenyatta National Hospital

Intra-abdominal hypertension (IAH) affects almost every organ sytem.If it is not detected early and corrected, mortality would be high. The prevalence of IAH and abdominal compartment syndrome (ACS) at Kenyatt...

Authors: A. Muturi, P. Ndaguatha, Daniel Ojuka and A. Kibet

Aerial medical evacuation of health workers with suspected Ebola virus disease in Guinea Conakry-interest of a negative pressure isolation pod-a case series

We report 4 cases of Health Workers (HW) suspected of having contracted Ebola Virus Disease (EVD), transported from the Alliance for International Medical Action (ALIMA) Ebola Treatment Centre (ETC) in N’Zerek...

Authors: Jean-Michel Dindart, Olivier Peyrouset, Romain Palich, Abdoul Bing, Richard Kojan, Solenne Barbe, Souley Harouna and Nikki Blackwell

Effectiveness of a community paramedic-led health assessment and education initiative in a seniors’ residence building: the Community Health Assessment Program through Emergency Medical Services (CHAP-EMS)

Seniors living in subsidized housing have lower income, poorer health, and increased risk for cardiometabolic diseases and falls. Seniors also account for more than one third of calls to Emergency Medical Serv...

Authors: G. Agarwal, R. Angeles, M. Pirrie, F. Marzanek, B. McLeod, J. Parascandalo and L. Dolovich

Improved recognition of ineffective chest compressions after a brief Crew Resource Management (CRM) training: a prospective, randomised simulation study

Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patie...

Authors: Leopold Haffner, Moritz Mahling, Alexander Muench, Christoph Castan, Paul Schubert, Aline Naumann, Silke Reddersen, Anne Herrmann-Werner, Jörg Reutershan, Reimer Riessen and Nora Celebi

A nationwide survey of first aid training and encounters in Norway

Bystander first aid can improve survival following out-of-hospital cardiac arrest or trauma. Thus, providing first aid education to laypersons may lead to better outcomes. In this study, we aimed to establish ...

Authors: Håkon Kvåle Bakke, Tine Steinvik, Johan Angell and Torben Wisborg

A review of enhanced paramedic roles during and after hospital handover of stroke, myocardial infarction and trauma patients

Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfe...

Authors: Darren Flynn, Richard Francis, Shannon Robalino, Joanne Lally, Helen Snooks, Helen Rodgers, Graham McClelland, Gary A. Ford and Christopher Price

Erratum to: Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study

Authors: Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati and Stephen Kasiima

A qualitative study to identify barriers to deployment and student training in the use of automated external defibrillators in schools

Student training in use of automated external defibrillators and deployment of such defibrillators in schools is recommended to increase survival after out-of-hospital cardiac arrest. Low implementation rates ...

Authors: Line Zinckernagel, Carolina Malta Hansen, Morten Hulvej Rod, Fredrik Folke, Christian Torp-Pedersen and Tine Tjørnhøj-Thomsen

Emergency department presentations for atrial fibrillation and flutter in Alberta: a large population-based study

Atrial fibrillation or flutter (AFF) are not infrequent presenting problems in Emergency Departments (ED); however, little is known of the pattern of these presentations. This study provides a description of A...

Authors: Rhonda J. Rosychuk, Michelle M. Graham, Brian R. Holroyd and Brian H. Rowe

Factors affecting the exposure, vulnerability and emergency medical service capacity for victims of road traffic incidents in Kampala Metropolitan Area: a Delphi study

The Kampala Metropolitan Area (KMA) is the fastest developing region in Uganda. Over recent years, this has placed exponential demand on the road sector, which consequently has contributed to rapid growth in m...

Authors: Joseph Kimuli Balikuddembe, Ali Ardalan, Davoud Khorasani-Zavareh, Amir Nejati and Stephen Kasiima

Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis

Survival rates from out-of-hospital cardiac arrest (OHCA) remain low, despite remarkable efforts to improve care. A number of ambulance services in the United Kingdom (UK) have developed prehospital critical c...

Authors: Johannes von Vopelius-Feldt, Jane Powell, Richard Morris and Jonathan Benger

The Sydney Triage to Admission Risk Tool (START) to predict Emergency Department Disposition: A derivation and internal validation study using retrospective state-wide data from New South Wales, Australia

Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Em...

Authors: Michael M. Dinh, Saartje Berendsen Russell, Kendall J. Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R. Chalkley and Rebecca Ivers