Emergency Research Papers - Academia.edu (original) (raw)

To assess the effectiveness of the PAST (Pre-hospital Acute Stroke Triage) protocol in reducing pre-hospital and emergency department (ED) delays to patients receiving organised acute stroke care, thereby increasing access to thrombolytic... more

To assess the effectiveness of the PAST (Pre-hospital Acute Stroke Triage) protocol in reducing pre-hospital and emergency department (ED) delays to patients receiving organised acute stroke care, thereby increasing access to thrombolytic therapy. Prospective cohort study using historical controls. Hunter Region of New South Wales, September 2005 to March 2006 (pre-intervention) and September 2006 to March 2007 (post-intervention). Consecutive patients presenting with acute stroke to a regional, tertiary referral hospital. PAST protocol, comprising a pre-hospital stroke assessment tool for ambulance officers, an ambulance protocol for hospital bypass for potentially thrombolysis-eligible patients, and pre-hospital notification of the acute stroke team. Proportion of patients who received intravenous tissue plasminogen activator (tPA), process of care time points (symptom onset to ED arrival, ED arrival to tPA treatment, and ED transit time), and clinical outcomes of patients treated...

The study aim was to test whether a brief motivational intervention, with or without a booster session, would improve drinking-related outcomes more than standard Emergency Department (ED) treatment. The study population consisted of 539... more

The study aim was to test whether a brief motivational intervention, with or without a booster session, would improve drinking-related outcomes more than standard Emergency Department (ED) treatment. The study population consisted of 539 (78% male) injured patients treated in the ED and discharged to the community following their treatment. Injured patients met inclusion criteria if they were assessed as hazardous or harmful drinkers by scoring eight or more on the AUDIT and/or having alcohol in their system at the time of their injury or ED visit. Patients were randomly assigned to either standard care (SC), brief intervention (BI) or brief intervention plus a booster session (BIB). At 1-year follow-up, 447 patients (83% of the sample) were re-interviewed to measure alcohol-related negative consequences, injuries and drinking. Patients receiving BIB, but not B1 patients, reduced alcohol-related negative consequences and alcohol-related injuries more than did those in the SC group. ...

Objective To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia.Design Facility-based cross-sectional study.Setting Four maternity hospitals in La Paz and El Alto,... more

Objective To document the frequency and causes of maternal mortality and severe (near-miss) morbidity in metropolitan La Paz, Bolivia.Design Facility-based cross-sectional study.Setting Four maternity hospitals in La Paz and El Alto, Bolivia, where free maternal health care is provided through a government-subsidised programme.Population All maternal deaths and women with near-miss morbidity.Methods Inclusion of near-miss using clinical and management-based criteria.Main outcome measures Maternal mortality ratio (MMR), severe morbidity ratio (SMR), mortality indices and proportion of near-miss cases at hospital admission.Results MMR was 187/100 000 live births and SMR was 50/1000 live births, with a relatively low mortality index of 3.6%. Severe haemorrhage and severe hypertensive disorders were the main causes of near-miss, with 26% of severe haemorrhages occurring in early pregnancy. Sepsis was the most common cause of death. The majority of near-miss cases (74%) were in cr...

Quality assurance programmes have become an accepted part of health care delivery in hospitals in a number of countries. In addition to their value as management and clerical systems designed to ensure that clinical care is of an... more

Quality assurance programmes have become an accepted part of health care delivery in hospitals in a number of countries. In addition to their value as management and clerical systems designed to ensure that clinical care is of an acceptable standard,' they have also become popular ...

Outbreaks of highly contagious animal diseases severely affect the global economy, seriously disrupting domestic economies and the international trade of livestock and animal commodities. Italy has a series of contingency plans for the... more

Outbreaks of highly contagious animal diseases severely affect the global economy, seriously disrupting domestic economies and the international trade of livestock and animal commodities. Italy has a series of contingency plans for the management of outbreaks of all major animal diseases. Disease control measures are mainly based on a traditional approach and eradication policies range from culling and stamping-out to movement restrictions of animals and commodities. Given the marked terrain differences in Italy, the uneven distribution of farms and animal population, the presence of potential disease hotspots constituted by high-density clusters of farms and animals, etc., maps have always been a common working tool for the Italian veterinary services to identify location of premises, define the perimeter of the infected and control zones, etc. The Italian Ministry of Health has requested an integrated system for the management of veterinary emergencies. One of the main features of the system is an interactive, customisable and user-friendly Web-based geographic information system (GIS). The Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G. Caporale’ has been entrusted with the development of a system that provides different administrative levels with a spatial decisional and management tool to assist them in case of epidemics. A Web-based GIS has been designed to integrate epidemiological information with the corresponding geographic component. The system works on a disease basis (disease-specific maps) for fifteen of the most contagious diseases and is accessible through the Web, allowing for real-time recording of new outbreaks

To determine the utility of the lateral view of the chest in emergency department patients, records of all patients who had had 2-view chest x-rays ordered in the emergency department were reviewed retrospectively. A study radiologist... more

To determine the utility of the lateral view of the chest in emergency department patients, records of all patients who had had 2-view chest x-rays ordered in the emergency department were reviewed retrospectively. A study radiologist recorded a reading of the posteroante-riot (PA) ...

Abstract. Concerns regarding the safety of nifedipine emerged in 1995 with the report of an increased risk of myocardial infarction associated with adult patients receiving short-acting calcium channel blockers. There have been few case... more

Abstract. Concerns regarding the safety of nifedipine emerged in 1995 with the report of an increased risk of myocardial infarction associated with adult patients receiving short-acting calcium channel blockers. There have been few case reports of adverse events in children ...

Making decisions to call emergency assistance to patients is an important dimension of nursing practice. Most usually these decision making situations are uncertain and it is expected nurses rely on past clinical experiences. This study,... more

Making decisions to call emergency assistance to patients is an important dimension of nursing practice. Most usually these decision making situations are uncertain and it is expected nurses rely on past clinical experiences. This study, approved by the ethics committees of both a university and an area health service, aimed to describe nurses' reliance on past experiences and identify associated judgement strategies (heuristics). Thirty-two registered nurses with five or more years experience were interviewed. Main findings were: nurses did use their past experiences and these experiences were used in the form of the three "classic" heuristics, representativeness, availability and anchoring and adjustment. It can be concluded past experiences are intrinsic to decision making and this has implications for both the clinical components of nursing educational programs and staffing allocations made by administrators. Some nurses, however, did not include referral to past e...

To investigate the knowledge, practices, and attitudes among students at a university in Ghana regarding emergency contraception (EC).An anonymous, self-administered, 39-item questionnaire was sent to 3200 students. The sample size was... more

To investigate the knowledge, practices, and attitudes among students at a university in Ghana regarding emergency contraception (EC).An anonymous, self-administered, 39-item questionnaire was sent to 3200 students. The sample size was stratified and 2292 students were randomly selected.Of the 71.6% of students who responded, 51.4% had heard of EC. Among those, 19.4% thought EC consisted of contraceptive pills, 19.1% of “morning-after pills,” and 12.8% of an intrauterine device. Only 4.2% had ever used EC but 73.9% wished it were provided on campus. Of all the respondents, 90.9% called for the establishment of a reproductive health counseling center on campus.Student knowledge and use of EC were poor, and there is urgent need for reproductive counseling and EC services on campus.

In summer 2007, in the city of Athens, Greece, extremely high air temperatures were recorded, inducing heat discomfort conditions in the urban environment. Four biometeorological indices were calculated in order to evaluate human thermal... more

In summer 2007, in the city of Athens, Greece, extremely high air temperatures were recorded, inducing heat discomfort conditions in the urban environment. Four biometeorological indices were calculated in order to evaluate human thermal sensation and thermal comfort: Actual Sensation Vote (ASV), Thermal Sensation-Ginovi method (TS), Discomfort Index (DI) and Heat Load Index (HL). Data included measurements of ambient temperature, temperature of the surrounding ground surface, relative humidity, air pressure, wind velocity and solar radiation obtained from National Observatory of Athens (NOA) station. During this period the daily number of patients probably affected by heat in emergency department units of cardiac clinics of four public general hospitals in Athens was recorded. The results revealed high values of DI and HL indices, demonstrating severe heat stress conditions during the last ten day period of June and July, while the ASV tends to classify too many cases into the comfort zone compared to TS, DI and HL. The statistical analysis revealed a negative relationship between the number of heat affected patients and the estimated indices values.

This is a critical review of an article based on the experiences of Epidemic Preparedness and Response pillars as they built resilient health systems while responding to various emerging and re-emerging adverse events. The premise of the... more

This is a critical review of an article based on the experiences of Epidemic Preparedness and Response pillars as they built resilient health systems while responding to various emerging and re-emerging adverse events. The premise of the article is to explore the need and outline advantages of resilient health systems to those responsible for health outcomes at all levels, for effective public health action amidst adverse contexts. The article may be considered as objective and unbiased due to the peer review process. The article was published in a journal that provides a forum for a broad discussion of global health issues that range from systemic violence to infectious disease outbreaks. The article has contributed to literature and provides a basis for achieving resilience, improving public health action and indicates areas for further development of the knowledge base of health systems research. However, it is suggested that the concept of responsiveness be reemphasized and paired with resilience to improve the performance of health systems.

Người bị đuối nước cần phải có cách sơ cấp cứu thích hợp mới có thể cứu sống nạn nhân và đảm bảo an toàn cho bản thân