Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias最新文献

{"title":"Pharmacist care in hospital emergency departments: a consensus paper from the Spanish hospital pharmacy and emergency medicine associations.","authors":"Jesús Ruiz Ramos, Beatriz Calderón Hernanz, Yolanda Castellanos Clemente, Manuel Bonete Sánchez, Emili Vallve Alcon, M ª Rosario Santolaya Perrin, M ª Ángeles García Martín, Ana de Lorenzo Pinto, José Manuel Real Campaña, Javier Ramos Rodríguez, Cristina Calzón Blanco, Milagros García Peláez, Héctor Alonso Ramos, Joan Altimiras Ruiz, Paloma Sempere Serrano, María Martín Cerezuela, Leonor Periañez Parraga, Ana María Juanes Borrego, Beatriz Somoza Fernández, Juan Manuel Rodríguez Camacho, Mireia Puig Campmany, Iria Miguens Blanco, Santiago Tomás Vecina, Catalina Nadal Galmes, Javier Povar Marco","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To draft a list of actions and quality indicators for pharmacist care in hospital emergency departments, based on consensus among a panel of experts regarding which actions to prioritize in this setting.</p><p><strong>Material and methods: </strong>A panel of experts from the Spanish Society of Hospital Pharmacy (SEFH) and the Spanish Society of Emergency Medicine (SEMES) evaluated a preliminary list of potential actions and quality of care indicators. The experts used a questionnaire to assess the proposals on the basis of available evidence. In the first round, each expert individually assessed the importance of each proposed action based on 4 dimensions: evidence base, impact on clinical response and patient safety, ease of implementation, and priority. In the second round the experts attended a virtual meeting to reach consensus on a revised list of proposals; suggestions and comments that had been made anonymously in the first round were included. The group then prioritized each action as basic, intermediate, or advanced.</p><p><strong>Results: </strong>The experts evaluated a total of 26 potential actions and associated quality indicators. No items were eliminated in the analysis of scores and comments from the first round. After the second round, 25 actions survived. Nine were considered basic, 10 intermediate, and 6 advanced.</p><p><strong>Conclusion: </strong>The expert panel's list of pharmacist actions and care quality indicators provides a basis for developing a pharmacist care program in Spanish emergency departments on 3 levels of priority. The list can serve as a guide to pharmacists, managers, physicians, and nurses involved in the effort to improve drug therapy in this hospital setting.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"205-217"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute ataxia induced by nitrous oxide abuse in young adults during the COVID-19 pandemic.","authors":"Thierry Gendre, Hanna Ovaska, Rémy Nguyen, Anne-Catherine Bachoud-Levi, Mehdi Khellaf, Philippe Remy","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"225-227"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung ultrasound imaging used during transport of patients with neonatal respiratory compromise.","authors":"Marta Rodríguez Navarro, Ana Doménech Armisén, Julia Gómez Rodríguez, Montserrat Pujol Jover","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"227-229"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficiency of discharge to home hospitalization directly after emergency department care of patients with acute heart failure.","authors":"Carolina Sánchez Marcos, Begoña Espinosa, Emmanuel Coloma, David San Inocencio, Sonja Pilarcikova, Sergio Guzmán Martínez, Mariona Ramón, Alejandro Carratalá Ballesta, Omar Saavedra, Nicole Ivars Obermeier, Ernest Bragulat, Adriana Gil-Rodrigo, Ainoa Ugarte, Pere Llorens, Òscar Miró","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze whether discharge to home hospitalization (HHosp) directly from emergency departments (EDs) after care for acute heart failure (AHF) is efficient and if there are short-term differences in outcomes between patients in HHosp vs those admitted to a conventional hospital ward (CHosp).</p><p><strong>Material and methods: </strong>Secondary analysis of cases from the EAHFE registry (Epidemiology of Acute Heart Failure in Emergency Departments). The EAHFE is a multicenter, multipurpose, analytical, noninterventionist registry of consecutive AHF patients after treatment in EDs. Cases were included retrospectively and registered to facilitate prospective follow-up. Included were all patients diagnosed with AHF and discharged to HHosp from 2 EDs between March 2016 and February 2019 (3 years). Cases from 6 months were analyzed in 3 periods: March-April 2016 (corresponding to EAHFE-5), January-February 2018 (EAHFE-6), and January-February 2019 (EAHFE-7). The findings were adjusted for characteristics at baseline and during the AHF decompensation episode.</p><p><strong>Results: </strong>A total of 370 patients were discharged to HHosp and 646 to CHosp. Patients in the HHosp group were older and had more comorbidities and worse baseline functional status. However, the decompensation episode was less severe, triggered more often by anemia and less often by a hypertensive crisis or acute coronary syndrome. The HHosp patients were in care longer (median [interquartile range], 9 [7-14] days vs 7 [5-11] days for CHosp patients, P .001), but there were no differences in mortality during hospital care (7.0% vs. 8.0%, P = .56), 30-day adverse events after discharge from the ED (30.9% vs. 32.9%, P = .31), or 1-year mortality (41.6% vs. 41.4%, P = .84). Risks associated with HHosp care did not differ from those of CHosp. The odds ratios (ORs) for HHosp care were as follows for mortality while in care, OR 0.90 (95% CI, 0.41-1.97); adverse events within 30 days of ED discharge, OR 0.88 (95% CI, 0.62-1.26); and 1-year mortality, OR 1.03 (95% CI, 0.76-1.39). Direct costs of HHosp and CHosp averaged €1309 and €5433, respectively.</p><p><strong>Conclusion: </strong>After ED treatment of AHF, discharge to HHosp requires longer care than CHosp, but short- and longterm outcomes are the same and at a lower cost.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"176-184"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound guidance for arterial (other than femoral) catheterisation in adults.","authors":"Ronald Lg Flumignan, Virginia Fm Trevisani, Renato D Lopes, Jose Cc Baptista-Silva, Carolina Dq Flumignan, Luis Cu Nakano","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"218-220"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging epidemic of head injuries related to electric scooter use by under-18-year-olds.","authors":"María Iriondo Muruzábal, Carla González Grado, Victoria Trenchs Sainz de la Maza, Carles Luaces","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"229-230"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital care process and hospital outcomes in stroke-code cases: comparison of basic and advance life support ambulance attendance.","authors":"Silvia Solà Muñoz, María Del Mar Escudero Campillo, Cristina Soro Borrega, Youcef Azeli, Soledad Querol Gil, Antoni Ruiz, Gemma Albacete, Olga Moreno Peral, Sergi Lluch, Sergio Amaro Delgado, Yolanda Silva Blas, Xabier Urra, Dolores Cocho Calderón, Joan Martí Fàbregas, Marc Ribó Jacobi, Pere Cardona Portela, Francisco Purroy García, Esther Duarte Oller, Verónica Hidalgo Benítez, Alan Flores, Marta Rubiera, Ernest Palomeras, Álvaro García-Tornel, Rosa Suñer Soler, Daniel Vilar Roquet, Mercè Salvat-Plana, Anna Ramos Pachón, Natalia Pérez de la Ossa Herrero, Xavier Jiménez Fàbrega","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To study prehospital care process in relation to hospital outcomes in stroke-code cases first attended by 2 different levels of ambulance. To analyze factors associated with a satisfactory functional outcome at 3 months.</p><p><strong>Material and methods: </strong>Prospective multicenter observational cohort study. All stroke-code cases attended by prehospital emergency services from January 2016 to April 2022 were included. Prehospital and hospital variables were collected. The classificatory variable was type of ambulance attending (basic vs advanced life support). The main outcome variables were mortality and functional status after ischemic strokes in patients who underwent reperfusion treatment 90 days after the ischemic episode.</p><p><strong>Results: </strong>Out of 22 968 stroke-code activations, ischemic stroke was diagnosed in 12 467 patients (54.3%) whose functional status was good before the episode. Basic ambulances attended 93.1%; an advanced ambulance was ordered in 1.6% of the patients. Even though there were differences in patient and clinical characteristics recorded during the prehospital process, type of ambulance was not independently associated with mortality (adjusted odds ratio [aOR], 1.1; 95% CI, 0.77-1.59) or functional status at 3 months (aOR, 1.05; 95% CI, 0,72-1,47).</p><p><strong>Conclusion: </strong>The percentage of patient complications in stroke-code cases attended by basic ambulance teams is low. Type of ambulance responding was not associated with either mortality or functional outcome at 3 months in this study.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"167-175"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of 3 frailty scales for predicting adverse outcomes at 30 days in older patients discharged from emergency departments.","authors":"Cesáreo Fernández Alonso, Carmen Del Arco Galán, Raquel Torres Garate, José Fernando Madrigal Valdés, Rodolfo Romero Pareja, Carlos Bibiano Guillén, Belén Rodríguez Miranda, Martín S Ruiz Grinspan, Sonia Gutiérrez Gabriel, Ana Del Rey Ubago, Manuel E Fuentes Ferrer, Francisco Javier Martín-Sánchez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the ability of 3 frailty scales (the Clinical Frailty Scale [CFS], the Functional Index - eMergency [FIM], and the Identification of Seniors at Risk [ISAR] scale) to predict adverse outcomes at 30 days in older patients discharged from hospital emergency departments (EDs).</p><p><strong>Material and methods: </strong>Secondary analysis of data from the FRAIL-Madrid registry of patients aged 75 years or older who were discharged from Madrid EDs over a period of 3 months in 2018 and 2019. Frailty was defined by a CFS score over 4, a FIM score over 2, or an ISAR score over 3. The outcome variables were revisits to an ED, hospitalization, functional decline, death, and a composite variable of finding any of the previously named variables within 30 days of discharge.</p><p><strong>Results: </strong>A total of 619 patients were studied. The mean (SD) age was 84 (7) years, and 59.1% were women. The CFS identified as frail a total of 339 patients (54.8%), the FIM 386 (62.4%), and the ISAR 301 (48.6%). An adverse outcome occurred within 30 days in 226 patients (36.5%): 21.5% revisited, 12.6% were hospitalized, 18.4% experienced functional decline, and 3.6% died. The areas under the receiver operating characteristic curves were as follows: CFS, 0.66 (95% CI, 0.62-0.70; P = .022); FIM, 0.67 (95% CI, 0.62-0.71; P = .021), and ISAR, 0.64 (95% CI, 0.60-0.69; P = .023). Adjusted odds ratios (aOR) showed that frailty was an independent risk factor for presenting any of the named adverse outcomes: aOR for CFS >4, 3.18 (95% CI, 2.02-5.01), P .001; aOR for FIM > 2, 3.49 (95% CI, 2.15-5.66), P .001; and aOR for ISAR >3, 2.46 (95% CI, 1.60-3.79), P .001.</p><p><strong>Conclusion: </strong>All 3 scales studied - the CFS, the FIM and the ISAR - are useful for identifying frail older patients at high risk of developing an adverse outcome (death, functional decline, hospitalization, or revisiting the ED) within 30 days after discharge.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 3","pages":"196-204"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9685650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verbal de-escalation to reduce the use of mechanical restraint during nonvoluntary ambulance transfers.","authors":"David Córcoles Martínez, Sonia Ramos Perdigues, Anna M González Fresnedo, Magda Bellsolà González, Ángeles Malagón Amor, Luis M Martín López","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the usefulness of annual training in verbal de-escalation techniques for reducing the use of mechanical restraints during nonvoluntary ambulance transfers of patients with mental health problems who need emergency care.</p><p><strong>Material and methods: </strong>Quasi-experimental before-after study. Patients with mental diseases treated by a psychiatric team and transferred from home without their consent were included from January through December 2008 in Barcelona. Since 2013, the team had been attending annual training sessions in verbal de-escalation based on the recommendations of the BETA project (Best Practices in the Evaluation and Treatment of Agitation). We compared the prevalence of the use of mechanical restraint before and after the team started verbal de-escalation training. We also analyzed variables associated with the need to use restraints.</p><p><strong>Results: </strong>Patients in 633 nonvoluntary transfers were included. Mechanical restraints were used in 42.0% of transfers before de-escalation training and in 20.6% of transfers afterwards, reflecting a 50.1% reduction. Logistic regression identified younger age and the presence of psychotic symptoms as factors associated with the use of restraints; the use of verbal de-escalation was a protective factor (P 0.005).</p><p><strong>Conclusion: </strong>Annual training in verbal de-escalation techniques following the BETA project's recommendations led to a 50% reduction in the need to use mechanical restraint during nonvoluntary ambulance transfers of patients with mental health problems.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 2","pages":"97-102"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9462054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left bundle branch block and severe ventricular dysfunction due to flecainide toxicity: a case report.","authors":"Fernando Candanedo Ocaña, Miriam Auxiliadora Martín Toro, Francisco Javier Camacho Jurado, Mónica Martín Hidalgo, Pablo J González Pérez, Manuel S Herruzo Rojas, Francisco J Morales Ponce","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 2","pages":"159-160"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}