Association between the number of prehospital defibrillation attempts and a sustained return of spontaneous circulation: a retrospective, multicentre, registry-based study
Conclusions
We observed no significant increase in ROSC after five defibrillations, and no absolute increase in ROSC after seven defibrillations. These data provide a starting point for determination of the optimal defibrillation strategy prior to consideration for prehospital extracorporeal cardiopulmonary resuscitation (ECPR) or conveyance to a hospital with an ECPR capability.
Trial registration number
NCT03222999 (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Ko, B. S., Kim, Y.-J., Han, K. S., Jo, Y. H., Shin, J., Park, I., Kang, H., Lim, T. H., Hwang, S., Kim, W. Y. Tags: Original research Source Type: research
Bystander cardiopulmonary resuscitation and cardiac rhythm change over time in patients with out-of-hospital cardiac arrest
Conclusion
Bystander CPR was associated with a higher VF/VT likelihood and a lower likelihood of pulseless electrical activity at first documented rhythm analysis. Our results support early CPR for OHCA and highlight the need for further research to understand whether and how CPR modifies the cardiac rhythm after arrest. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Shibahashi, K., Kato, T., Hikone, M., Sugiyama, K. Tags: Original research Source Type: research
Man with neck pain
Clinical introduction A 43-year-old man without medical history presented to ED with a 10-day history of neck pain. At triage, his body temperature was 39.6oC and blood pressure was 95/55 mm Hg. On physical examination, there was posterior neck swelling and stiffness without neurological deficit. Blood tests revealed white cell count of 35 930/mm3 and C reactive protein of 29.6 mg/dL. Neck plain radiography was performed (figure 1). Question What is the most likely diagnosis? Cervical spine fracture Oesophageal rupture Meningitis Necrotising fasciitis Answer: D. Necrotising fasciitis (NF) The plain film showed multiple het...
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Liu, C.-I., Hsu, Y.-P., Kuo, C.-L. Tags: EMJ Image Challenge Source Type: research
Diagnostic accuracy of point-of-care lung ultrasound for COVID-19: a systematic review and meta-analysis
Conclusion
During a period of high prevalence, LUS had a sensitivity of 87% for the diagnosis of COVID-19 infection. However, more research is required to confirm these results in more generalisable populations, including those less likely to be admitted to hospital.
PROSPERO registration number
CRD42021250464 (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Matthies, A., Trauer, M., Chopra, K., Jarman, R. D. Tags: COVID-19 Systematic review Source Type: research
Improving communications in PPE: a solution for 'landline telephone communication
Conclusions
Introduction of a suitable headset could significantly improve speech intelligibility during ‘emergency alert’ telephone calls. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Coats, T. J., Pallett, E., Mangat, J., Chung, E. Tags: Original research Source Type: research
Cross-cultural adaptation and its impact on research in emergency care
The perspective of patients is increasingly recognised as important to care improvement and innovation. Patient questionnaires such as patient-reported outcome measures may often require cross-cultural adaptation (CCA) to gather their intended information most effectively when used in cultures and languages different to those in which they were developed. The use of CCA could be seen as a practical step in addressing the known problems of inclusion, diversity and access in medical research.
An example of the recent adaptation of a patient-reported outcome measure for use with ED patients is used to explore some key feature...
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Roberts, T., Carlton, E., Booker, M., Voss, S., Vaillancourt, S., Jafar, A. J. N., Benger, J. Tags: Practice review Source Type: research
Did Englands national home oxygen monitoring programme for COVID-19 work? Yes... and no
The article by Beaney and colleagues just published in the EMJ evaluates the outcomes from a national programme of home oxygen monitoring instituted by NHS England during the first waves of the COVID-19 pandemic.1 This may sound familiar; we ran a paper by this same author group on this subject in our August 2022 issue.2 At first glance, you might think we accidentally reran the same paper. Both studies ask what appears to be the same research question: was there benefit? However, the studies are indeed quite different in what effect they are examining. The study just published looks at whether patients who enrolled in the...
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Weber, E. J. Tags: COVID-19 Editorial Source Type: research
Primary survey: highlights from this issue
Hello and welcome to my first Primary Survey. I am the EMJ’s Social Media Editor and an Emergency Medicine Higher Specialist trainee in the East Midlands, UK. June 2023’s journal is packed with a smörgåsbord of articles on topics such as COVID-19, cardiology, risk stratification, and cross-cultural impact on research in emergency medicine. COVID-19 COVID-19 has undoubtedly had an impact on health care over recent years and continues to do so. Therefore, it is no surprise that papers on COVID-19 feature in this month's journal. This month’s editor’s choice by Beaney et al looks at the u...
Source: Emergency Medicine Journal - May 23, 2023 Category: Emergency Medicine Authors: Edwards, S. Tags: Highlights from this issue Source Type: research
Reply to Dr Hiraku Funakoshis letter 'Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department
We thank Dr Funakoshi1 for his interest in our article, ‘Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial’.2 Unfortunately, we did not record the reason for patients declining to participate. In my personal experience recruiting patients for this study, patients often do not consent because of practical reasons, such as not living in the area, physical difficulty of returning to the hospital, or the extra time it would cost to return to hospital as it is easier and q...
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Zwaans, J. J. M. Tags: PostScript Source Type: research
Letter to the editor: Non-sterile gloves and dressing versus sterile gloves, dressings and drapes for suturing of traumatic wounds in the emergency department: a non-inferiority multicentre randomised controlled trial
I read with interest the recently published article by Zwaans et al.1 This paper provides essential information about the safety of non-sterile gloves and dressing for suturing traumatic wounds in the ED. Conducting a nationwide randomised control trial is a considerable undertaking. I would like to emphasise the importance of this paper further. The biggest concern is the number of patients excluded. The number of patients who did not give consent amounts to 441, which is one-sixth of the total number of eligible patients. This large number of exclusions could create a selection bias and so clarification of the reasons fo...
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Funakoshi, H. Tags: PostScript Source Type: research
Journal update monthly top five
Introduction This month’s update is by the Department of Emergency Medicine, Stanford Medicine. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations, and clinical bottom line for each paper. The papers are ranked as Worth a peek—interesting but not yet ready for prime time. Head turner—new concepts. Game changer—this paper could/should change practice. The efficacy of prehospital IV fluid management in se...
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Nayak, R. U., Ravi, S., Kondayapalepu, P. S., Prabhakar, D., Govindarajan, P., Van Den Berg, P. Tags: Journal update Source Type: research
Abstracts from international emergency medicine journals
Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Production, E. Tags: Global emergency highlights Source Type: research
SONO case series: point-of-care ultrasound for Achilles tendon injury
Case presentation A 37-year-old man with no significant medical history presents complaints of pain and swelling of his left calf and ankle. Nine days prior to presentation, he felt a popping sensation in his left posterior ankle while pushing off to begin a sprint while exercising. He reports worsening pain and swelling of his left ankle extending into his left calf since the injury. On examination, the left calf and posterior ankle are swollen and erythematous compared with the contralateral side figure 1. Thompson’s test result is positive on the left side, indicating a rupture of the Achilles tendon. Motor functi...
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Neill, E., Shyy, W. Tags: SAQs Source Type: research
Clinical predictors of fracture in patients with shoulder dislocation: systematic review of diagnostic test accuracy studies
Conclusion
Clinical prediction rules may have a role in supporting shared decision making after shoulder dislocation, particularly in the prehospital and remote environments when delay to imaging is anticipated. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Oldrini, I., Coventry, L., Novak, A., Gwilym, S., Metcalfe, D. Tags: Systematic review Source Type: research
Risk factors that predict mortality in patients with blunt chest wall trauma: an updated systematic review and meta-analysis
Conclusions
The results of this updated review suggest that despite a change in demographics of trauma patients and subsequent emerging evidence over the last 10 years, the main risk factors for mortality in patients sustaining blunt chest wall trauma remained largely unchanged. A number of new risk factors however have been reported that need consideration when updating current risk prediction models used in the ED.
PROSPERO registration number
CRD42021242063. Date registered: 29 March 2021. https://www.crd.york.ac.uk/PROSPERO/%23recordDetails. (Source: Emergency Medicine Journal)
Source: Emergency Medicine Journal - April 21, 2023 Category: Emergency Medicine Authors: Battle, C., Carter, K., Newey, L., Giamello, J. D., Melchio, R., Hutchings, H. Tags: Systematic review Source Type: research
