Articles

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

Brief compression-only cardiopulmonary resuscitation training video and simulation with homemade mannequin improves CPR skills

Cardiopulmonary resuscitation (CPR) training has traditionally involved classroom-based courses or, more recently, home-based video self-instruction. These methods typically require preparation and purchase fe...

Authors: Gregory K. Wanner, Arayel Osborne and Charlotte H. Greene

Testing a videogame intervention to recalibrate physician heuristics in trauma triage: study protocol for a randomized controlled trial

Between 30 and 40 % of patients with severe injuries receive treatment at non-trauma centers (under-triage), largely because of physician decision making. Existing interventions to improve triage by physicians...

Authors: Deepika Mohan, Matthew R. Rosengart, Baruch Fischhoff, Derek C. Angus, Coreen Farris, Donald M. Yealy, David J. Wallace and Amber E. Barnato

Intranasal ketamine for acute traumatic pain in the Emergency Department: a prospective, randomized clinical trial of efficacy and safety

Ketamine has been well studied for its efficacy as an analgesic agent. However, intranasal (IN) administration of ketamine has only recently been studied in the emergency setting. The objective of this study w...

Authors: Shachar Shimonovich, Roy Gigi, Amir Shapira, Tal Sarig-Meth, Danielle Nadav, Mattan Rozenek, Debra West and Pinchas Halpern

Retrospective analysis of management of ingested foreign bodies and food impactions in emergency endoscopic setting in adults

Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted f...

Authors: Girolamo Geraci, Carmelo Sciume’, Giovanni Di Carlo, Antonino Picciurro and Giuseppe Modica

Comparison of antimicrobial resistance patterns of ESBL and non ESBL bacterial isolates among patients with secondary peritonitis at Bugando Medical Centre, Mwanza – Tanzania

Secondary peritonitis is a common surgical emergence with deadly outcomes when not timely and promptly intervened. The emergence of Extended spectrum beta lactamase producing bacteria (ESBL) poses treatment ch...

Authors: Jeremiah Seni, Enock Sweya, Amri Mabewa, Stephen E. Mshana and Japhet M. Gilyoma

Dispatch guideline adherence and response interval—a study of emergency medical calls in Norway

The Emergency Medical Communication Centre (EMCC) operators in Norway report using the Norwegian Index for Medical Emergency Assistance (Index), a criteria-based dispatch guideline, in about 75 % of medical em...

Authors: Eirin N. Ellensen, Torben Wisborg, Steinar Hunskaar and Erik Zakariassen

Primary triage nurses do not divert patients away from the emergency department at times of high in-hospital bed occupancy - a retrospective cohort study

Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs....

Authors: Mathias C Blom, Karin Erwander, Lars Gustafsson, Mona Landin-Olsson, Fredrik Jonsson and Kjell Ivarsson

Outcomes associated with observation versus short-stay admission among chest pain patients in the Veterans Health Administration

To determine the extent to which 30- and 90-day hospital readmission and mortality rates differ as a function of whether a chest pain patient is placed in observation status or admitted to the hospital for a s...

Authors: Brad Wright, Amy M. J. O’Shea, Justin M. Glasgow, Padmaja Ayyagari and Mary Vaughan-Sarrazin

Keep it simple: vascular risk factors and focal exam findings correctly identify posterior circulation ischemia in “dizzy” patients

Dizziness is a common chief complaint of patients presenting to the Emergency Department (ED). Physicians must quickly and accurately identify patients whose etiology is most likely ischemia. Additional tools ...

Authors: Karen Chen, Andrea L. C. Schneider, Rafael H. Llinas and Elisabeth B. Marsh

Barriers in detecting elder abuse among emergency medical technicians

Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians’ (EMTs), despite state-mandated report...

Authors: Jennifer M. Reingle Gonzalez, M. Brad Cannell, Katelyn K. Jetelina and Sepeadeh Radpour

The incorporation of focused history in checklist for early recognition and treatment of acute illness and injury

Diagnostic error and delay are critical impediments to the safety of critically ill patients. Checklist for early recognition and treatment of acute illness and injury (CERTAIN) has been developed as a tool th...

Authors: Namita Jayaprakash, Rashid Ali, Rahul Kashyap, Courtney Bennett, Alexander Kogan and Ognjen Gajic

Heart Fatty Acid Binding Protein and cardiac troponin: development of an optimal rule-out strategy for acute myocardial infarction

Improved ability to rapidly rule-out Acute Myocardial Infarction (AMI) in patients presenting with chest pain will promote decongestion of the Emergency Department (ED) and reduce unnecessary hospital admissio...

Authors: Joanna M. Young, John W. Pickering, Peter M. George, Sally J. Aldous, John Wallace, Chris M. Frampton, Richard W. Troughton, Mark A. Richards, Jaimi H. Greenslade, Louise Cullen and Martin P. Than

Psychological distress in medical patients 30 days following an emergency department admission: results from a prospective, observational study

Psychological distress in medical patients admitted to the emergency department (ED) is not well studied. Our aim was to investigate the extent of psychological distress in a broad and unselected medical patie...

Authors: Lukas Faessler, Alexander Kutz, Sebastian Haubitz, Beat Mueller, Pasqualina Perrig-Chiello and Philipp Schuetz

Early prediction of outcome after severe traumatic brain injury: a simple and practical model

Traumatic brain injury (TBI) is a heterogeneous syndrome with a broad range of outcome. We developed a simple model for long-term outcome prognostication after severe TBI.

Authors: Sandro Rizoli, Ashley Petersen, Eileen Bulger, Raul Coimbra, Jeffrey D. Kerby, Joseph Minei, Laurie Morrison, Avery Nathens, Martin Schreiber and Airton Leonardo de Oliveira Manoel