References of "European Journal of Emergency Medicine"
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See detailAIR VERSUS GROUND TRANSPORT OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: EXPERIENCE IN A RURAL-BASED HELICOPTER MEDICAL SERVICE
MOENS, Didier ULg; Stipulante, Samuel ULg; Donneau, Anne-Françoise ULg et al

in European Journal of Emergency Medicine (in press)

Aims Primary pre-hospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We ... [more ▼]

Aims Primary pre-hospital 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 EMS ground transport. Methods & results This prospective study was conducted from July 1, 2007 to June 15, 2012. Successive patients with ST-segment elevation myocardial infarction (STEMI) eligible for percutaneous coronary intervention (PCI) were included. Simulated ground-based access times were computed using a digital cartographic program, allowing the estimation of healthcare system delay from call to admission to the catheterisation laboratory. During the study period, 4485 patients benefited from HEMS activations. Of these patients, 342 (8%) suffering from STEMI were transferred for primary PCI. Median primary response time time was 11 min (IQR: 8 - 14 min) using the helicopter and 32 min (25 – 44 min) using road transport. Median transport time using HEMS was 12 min (9 – 15 min) and 50 min (36 – 56 min) by road. The median system delay using HEMS was 52 min (45 – 60 min), while this time was 110 min (95 – 126 min) by road. Finally, the system delay median gain was 60 min (47 – 72 min). Conclusions Using HEMS in a rural region allows STEMI patients to benefit from appropriate rescue care with similar delays as those seen in urban patients. [less ▲]

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See detailCognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?
Gillet, Aline ULg; GHUYSEN, Alexandre ULg; BONHOMME, Suzanne ULg et al

in European Journal of Emergency Medicine (2012)

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 ... [more ▼]

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. RESULTS: Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. CONCLUSION: The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care. [less ▲]

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See detailAre Belgian hospitals prepared for an H5NI1-pandemic?
De Cauwer, H. G.; Mortelmans, L. J. M.; D'Orio, Vincenzo ULg

in European Journal of Emergency Medicine (2007), 14(4), 204-206

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 ... [more ▼]

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. Many patients, including children, may require artificial ventilation within 48h after admission. Methods A survey aimed at determining 'availability and preparedness' was sent by e-mail to the different Belgian Emergency Departments. Results and discussion Sixty-five hospitals were finally included. The amount of patients being potentially admitted is limited, owing to the reduced number of intensive care beds equipped with automatic ventilators. Furthermore, the number of available intensive care beds for children is still lower than for adult patients. The number of mortuary places, in the case of a catastrophe, is also insufficient. Although most hospitals set up a disaster plan on H5N1, there are only limited stocks of antiviral medication to protect the hospital staff in the acute phase. A separate triage area is only available in a limited number of hospitals. We conclude that Belgian hospitals and emergency departments are not equipped to deal with potential pandemic situations. [less ▲]

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See detailInfective Endocarditis: Prevention, Diagnosis and Management
Pierard, Luc ULg; LANCELLOTTI, Patrizio ULg; Galiuto, L.

in European Journal of Emergency Medicine (1994), 1(2), 104-9

Infective endocarditis remains an important problem and the means of prevention are still insufficient. The causal bacteria have changed very little, but the incidence of nosocomial infections and ... [more ▼]

Infective endocarditis remains an important problem and the means of prevention are still insufficient. The causal bacteria have changed very little, but the incidence of nosocomial infections and endocarditis complicating intravenous drug abuse are increasing. The distinction between subacute and acute clinical presentations remains appropriate. Cardiac and neurological complications are frequent and carry a high risk of mortality. The diagnosis is obtained by the integration of clinical data and the results of blood cultures. Echocardiography is extremely useful for detecting vegetations, and for assessing the haemodynamic consequences and specific cardiac complications. Risk stratification can be obtained by correct integration of multiple parameters. The causal agent should be identified before the initiation of antimicrobial therapy. Surgery is frequently required, and should be performed rapidly when indicated. [less ▲]

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