Monitoring intervention programmes for out-of-hospital cardiac arrest in a mixed urban and rural setting.

Background: Only a few data are available on the survival rate following out-of-hospital cardiac arrest in different Italian settings. We report an analysis of a 10-year experience in a mixed rural/urban setting, the main variables associated with survival, and the preliminary results of the implementation of an automated external defibrillator (AED) programme operated by lay volunteers on the effectiveness of the existing Emergency Medical Service (EMS).

Methods: We report data from an observational cohort study on all adults, resuscitated from witnessed cardiac arrest between 1994 and 2004 in the district area of Forlì (Italy).

Clinical performance of NICE recommendations versus NCWFNS proposal in patients with mild head injury.

Recommendations on treatment of patients with head injury were recently proposed by the National Institute for Clinical Excellence (NICE). We tested the clinical performance of NICE variables versus the proposal of the Neurotraumatology Committee of the World Federation of Neurosurgical Societies (NCWFNS). Over a 5-year period, the clinical data of 7,955 adolescent and adult patients with mild head injury were prospectively collected and patients were managed according to the NCWFNS proposal.

Which type of observation for patients with high-risk mild head injury and negative computed tomography?

Objective: Current guidelines suggest hospital admission followed by home monitoring for high-risk patients with mild head injury and negative computed tomography scan. We tested early home monitoring under the care of a competent observer.

Methods: A total of 1480 patients with mild head injury and negative computed tomography scan were prospectively studied.

Prospective validation of a proposal for diagnosis and management of patients attending the emergency department for mild head injury.

Background: In mild head injury, predictors to select patients for computed tomography (CT) and/or to plan proper management are needed. The strength of evidence of published recommendations is insufficient for current use. We assessed the diagnostic accuracy and the clinical validity of the proposal of the Neurotraumatology Committee of the World Federation of Neurosurgical Societies on mild head injury from an emergency department perspective.