Advanced triage to redirect non-urgent Emergency Department visits to alternative care centers: the PERSEE algorithm.

Objectives: Primary care treatable visits in the Emergency Department (ED) are part of the different factors leading to the overcrowding. Their triage and diversion to alternative care centers could potentially help manage the increasing inflow provided the establishment of an advanced triage to ensure patients' safety. We aim to suggest a new triage tool, PERSEE, and prove its feasibility, safety and performance.

Development and validation of a predictive model to determine the level of care in patients confirmed with COVID-19.

Background: The COVID-19 pandemic has imposed significant challenges on hospital capacity. While mitigating unnecessary crowding in hospitals is favourable to reduce viral transmission, it is more important to prevent readmissions with impaired clinical status due to initially inappropriate level of care. A validated predictive tool to assist clinical decisions for patient triage and facilitate remote stratification is of critical importance.

Clinical decision support tool for diagnosis of COVID-19 in hospitals.

Background: The coronavirus infectious disease 19 (COVID-19) pandemic has resulted in significant morbidities, severe acute respiratory failures and subsequently emergency departments' (EDs) overcrowding in a context of insufficient laboratory testing capacities. The development of decision support tools for real-time clinical diagnosis of COVID-19 is of prime importance to assist patients' triage and allocate resources for patients at risk.

Methods And Principal Findings: From March 2 to June 15, 2020, clinical patterns of COVID-19 suspected patients at admission to the EDs of Liège University Hospital, consisting in the recording of eleven symptoms (i.

Immersion in an emergency department triage center during the Covid-19 outbreak: first report of the Liège University hospital experience.

Objectives: Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective solution proposed in disaster medicine, also works well to manage Emergency Department (ED) flow. The aim of this study was to describe the role of an ED Triage Center for patients with suspected novel coronavirus disease (Covid-19) and characterize the patient flow.

Emergency department crowding: why do patients walk-in?

: For years, general practitioners (GP) shortage and patients' increasing demand for acute care have been associated with Emergency Department (ED) crowding. Indeed, EDs admissions for non-emergency care seem to constantly increase. Surprisingly, the rationale for patients own decision to directly reach EDs over primary care have been poorly investigated to date.

Parsonage-Turner Syndrome as a Rare Extrahepatic Complication of Hepatitis E Infection.

Unlabelled: Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered, among other factors, by some viral infections, although its pathophysiology remains unclear. Moreover, it has rarely been related to hepatitis E virus infection.

Triage for out-of-hours primary care calls: a reliability study of a new French-language algorithm, the SALOMON rule.

Triage systems for out-of-hours primary care physician (PCP) calls have been implemented empirically but no triage algorithm has been validated to date. A triage algorithm named SALOMON (Système Algorithmique Liégeois d'Orientation pour la Médecine Omnipraticienne Nocturne) was developed to guide triage nurses. This study assessed the performance of the algorithm using simulated PCP calls.

Interactive videoconferencing versus audio telephone calls for dispatcher-assisted cardiopulmonary resuscitation using the ALERT algorithm: a randomized trial.

Objectives: The ALERT algorithm, a telephone cardiopulmonary resuscitation (CPR) protocol, has been shown to help bystanders initiate CPR. Mobile phone communications may play a role in emergency calls and improve dispatchers' understanding of the rescuer's situation. However, there is currently no validated protocol for videoconference-assisted CPR (v-CPR).

Prevention of ventilator-associated pneumonia and ventilator-associated conditions: a randomized controlled trial with subglottic secretion suctioning.

Objectives: Ventilator-associated pneumonia diagnosis remains a debatable topic. New definitions of ventilator-associated conditions involving worsening oxygenation have been recently proposed to make surveillance of events possibly linked to ventilator-associated pneumonia as objective as possible. The objective of the study was to confirm the effect of subglottic secretion suctioning on ventilator-associated pneumonia prevalence and to assess its concomitant impact on ventilator-associated conditions and antibiotic use.

Air versus ground transport of patients with acute myocardial infarction: experience in a rural-based helicopter medical service.

Aims: Primary prehospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We designed a prospective study involving patients with acute myocardial infarction aimed at the evaluation of the potential benefit of such primary HEMS interventions as compared with classical Emergency Medical Services ground transport.

Methods And Results: This prospective study was conducted from 1 July 2007 to 15 June 2012.

Reliability and validity of a new French-language triage algorithm: the ELISA scale.

Objective: Overcrowding in emergency departments (ED) leads to reductions in quality of care. Consequently, several different triage tools have been developed to prioritise patient intake. Differences in emergency medical services in different countries have limited the generalisation of pre-existing triage systems; for this reason, specific algorithms corresponding to local characteristics are needed.

A fatal case of Perthes syndrome.

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of this syndrome. Current treatment is symptomatic: urgent relief of chest compression and cardiopulmonary resuscitation if needed.

Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres.

Objectives: Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area.

Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?

Aim: To improve the communication during shift handover in an emergency department.

Methods: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling.

Arterial dP/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved.

Background: Peak first derivative of femoral artery pressure (arterial dP/dtmax) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dtmax is reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced shock and catecholamine infusion.

Methods: Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated pigs.

Mathematical multi-scale model of the cardiovascular system including mitral valve dynamics. Application to ischemic mitral insufficiency.

Background: Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models would offer the ability to better understand these dynamics and thus optimize diagnosis, as well as surgical and other interventions.

Dispatcher-assisted telephone cardiopulmonary resuscitation using a French-language compression-only protocol in volunteers with or without prior life support training: A randomized trial.

Objectives: Due to the recent interest in hands-only protocols for dispatcher-assisted cardiopulmonary resuscitation (CPR) and the lack of any validated algorithms in French, our primary objective was to evaluate a new French-language protocol in terms of its efficacy to help previously untrained volunteers in performing basic life support efforts of appropriate quality, and secondarily to investigate its potential utility in subjects with previous training.

Methods: Untrained volunteers were recruited among adults in a public movie centre and previously trained volunteers among undergraduate nursing students. Participants were randomly assigned to 'phone CPR' versus 'no phone CPR' by drawing sets of envelopes.

Alteration of right ventricular-pulmonary vascular coupling in a porcine model of progressive pressure overloading.

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV performance in a porcine model of progressive pulmonary embolism. Twelve anesthetized pigs were randomly divided into two groups: gradual pulmonary arterial pressure increases by three injections of autologous blood clot (n=6) or sham-operated controls (n=6).

Are Belgian hospitals prepared for an H5N1-pandemic?

Objective: Virulent airborne diseases can be a real burden to a nation's health system. The most recent threat is the fear of a mutation-induced H5N1-influenza pandemic. We studied whether Belgian hospitals are able to deal with H5N1-influenza infected patients in the case of a pandemic.