People with autism spectrum disorder visit emergency departments more frequently than the rest of the population. Their ability to communicate with their environment may not only be limited but also different from the interactions of non-autistic people. In addition, the multiple sensory stimulations present in the emergency departments are likely to make interactions, and therefore the care of patients with an autism spectrum disorder more difficult.
View Article and Find Full Text PDFAims: The main objective of this study was to describe patients who were involuntarily admitted to the emergency department of Lausanne University Hospital on involuntary admission in 2018 in terms of age, gender, emergency department length of stay, the motive for involuntary admission, use of psychoactive substances, diagnosis, and destination at emergency department discharge, with or without discontinuation of involuntary admission.
Methods: This retrospective, observational, and monocentric study included patients 18 years and older admitted to the emergency department of Lausanne University Hospital on involuntary admission from January 1, 2018, to December 31, 2018. Patients were identified by the Cantonal Medical Office of Vaud.
Acute agitation is a frequent cause of emergency department's consultation. Managing an agitated patient is complex due to many factors and require from healthcare teams a close interdisciplinary collaboration. Scope of this article is to describe the management of agitated patients in an emergency department and to present an interprofessional medical care protocol (white code protocol), giving also the opinion of principal actors of this healthcare interdisciplinary model.
View Article and Find Full Text PDFObjective: We aimed to assess if emergency department (ED) syndromic surveillance during the first and second waves of the COVID-19 outbreak could have improved our surveillance system.
Design And Settings: We did an observational study using aggregated data from the ED of a university hospital and public health authorities in western Switzerland.
Participants: All patients admitted to the ED were included.
Background: Basic life support (BLS) is the first link in the chain of survival and should be performed by every lay rescuer. Although international studies have suggested that BLS knowledge was poor among the overall population, Swiss data are scarce. Our objective in this study was to evaluate BLS knowledge among Swiss conscripts, a semi-representative sample of Swiss young adults, during the recruitment process and to identify potential characteristics related to performance.
View Article and Find Full Text PDFBackground: Workplace violence is a serious and increasing problem in health care. Nevertheless, only few studies were carried out concerning this topic and then mainly in English-speaking countries. The objectives were to describe the acts of violence experienced by prehospital emergency care providers (PECPs) in the western part of Switzerland between January and December 2016 and to assess the consequences for subsequent PECPs behaviors.
View Article and Find Full Text PDFScand J Trauma Resusc Emerg Med
December 2021
Background: Noninvasive ventilation (NIV) is recognized as first line ventilatory support for the management of acute pulmonary edema (APE) and chronic obstructive pulmonary disease (COPD) exacerbations. We aimed to study the prehospital management of patients in acute respiratory distress with an indication for NIV and whether they received it or not.
Methods: This retrospective study included patients ≥18 years old who were cared for acute respiratory distress in a prehospital setting.
Alerting emergency medical services, rapidly initiating chest compressions at the correct depth and frequency and delivering an electric shock as quickly as possible remain the key points of the updated guidelines for adult cardiopulmonary resuscitation (CPR). Following their five-year systematic review, both the American Heart Association (AHA) and the European Resuscitation Council (ERC) are reinforcing their messages in favour of simple and early actions, while adding nuances regarding drugs, and suggesting that the chain of survival should continue beyond the acute hospital phase. Here is an overview of the reminders and novelties of the AHA and ERC 2020 guidelines.
View Article and Find Full Text PDFSmartphones and connected devices allow patients to monitor their health in a variety of ways. We report the case of a patient presenting to the emergency department complaining of palpitations and syncope. Standard investigations were unremarkable.
View Article and Find Full Text PDFObjective: We aimed to clarify the definition, epidemiology, and pathophysiology of excited delirium syndrome (ExDS) and to summarize evidence-based treatment recommendations.
Methods: We conducted a systematic literature search of MEDLINE, Ovid, Web of Knowledge, and Cochrane Library for articles published to March 18, 2017. We also searched the gray literature (Google Scholar) and official police or medical expert reports to complete specific epidemiologic data.
Many of our medical procedures are conditioned by beliefs or experiences by our mentors, which we pass on to the younger, for example: gradually emptying a full bladder to avoid hypotension or haemorrhage, hydrating the alcoholic so that the blood alcohol level decreases faster, always obtaining an arterial blood gas instead of a venous one and not injecting iodinated intravenous contrast in patients allergic to shellfish.
View Article and Find Full Text PDFSeveral articles have been published during 2016 suggesting amendments in certain established practices of emergency medicine. Amongst such practices now in question are : 1) the use in mechanical cardiopulmonary resuscitation of amiodarone and lidocaine which appear not to improve survival or neurological outcome ; 2) apneic oxygenation being associated with a significant increase in first pass success intubation ; 3) an updating of the definition of sepsis and septic shock which facilitate earlier identification of susceptible patients ; 4) the use of the high sensitivity troponin 0-hour / 1-hour algorithm which differentiates earlier patients with or without acute myocardial infarction ; 5) that intramuscular non-steroidal anti-inflammatory drugs offer effective sustained analgesia for renal colic, and finally 6) that irrigation of an abscess cavity after incision and drainage is not beneficial.
View Article and Find Full Text PDFThe objective is to describe the characteristics of mechanically restrained patients in the emergency department (ED) of a university hospital and to evaluate the quality of restraint documentation that was filled out according to the dedicated protocol with respect to the law on restraint. All adult patients (≥16 years) who were admitted to the ED from January 2009 to December 2010 and were mechanically restrained were included. We assessed medical and demographic characteristics, the completeness of the dedicated protocol, and the concomitant use of chemical sedation.
View Article and Find Full Text PDFThe morbidity and mortality of the 2014-2015 influenza season were more important than those in previous years. We assessed the impact of the 2014-2015 influenza season on the length of stay (LOS) and workload in an academic emergency department (ED). This is a monocentric retrospective study.
View Article and Find Full Text PDFThe year 2015 was marked by several publications questioning the practice of emergency medicine. The systematic administration of oxygen in STEMI patients offers no benefit. Similarly, medical expulsive therapy in patients with ureteric stones was questioned.
View Article and Find Full Text PDFPurpose: Obstructive sleep apnea syndrome (OSA) increases the risk of cardiovascular disease. We aimed at evaluating the effect of continuous positive airway pressure (CPAP) treatment on coronary endothelium-dependent vasoreactivity in OSA patients by quantifying myocardial blood flow (MBF) response to cold pressure testing (CPT).
Methods: In the morning after polysomnography (PSG), all participants underwent a dynamic (82)Rb cardiac positron emitting tomography/computed tomography (PET/CT) scan at rest, during CPT and adenosine stress.
New evidences published this year are susceptible to change the management of several medical emergencies. Combined antiplatelet therapy might be beneficial for the management of TIA or minor stroke and rapid blood pressure lowering might improve the outcome in patients with intracerebral hemorrhage. A restrictive red cell transfusion strategy is indicated in case of upper digestive bleeding and coagulation factors concentrates are superior to fresh frozen plasma for urgent warfarin reversal.
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