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

{"title":"Effects of midazolam vs morphine in patients with acute pulmonary edema with left ventricular systolic dysfunction: a secondary analysis of data from the MIMO trial.","authors":"Alberto Domínguez-Rodríguez, Daniel Hernández-Vaquero, Coral Suero-Méndez, Guillermo Burillo-Putze, Victor Gil, Rafael Calvo-Rodríguez, Pascual Piñera-Salmerón, Pere Llorens, Francisco J Martín-Sánchez, Pedro Abreu-González, Francesco Formica, Òscar Miró","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The midazolam vs morphine (MIMO) trial showed that patients treated with midazolam had fewer serious adverse events than those treated with morphine. In many patients with acute pulmonary edema, the left ventricular ejection fraction (LVEF) is preserved, at 50% or higher. We aimed to determine whether left ventricular (LV) systolic dysfunction (D), defined by an LVEF of less than 50%, modifies the protective effect of midazolam vs morphine.</p><p><strong>Material and methods: </strong>The MIMO trial randomized 111 patients with acute pulmonary edema to receive intravenous midazolam in 1-mg doses to a maximum of 3 mg (n = 55) or morphine in 2- to 4-mg doses to a maximum of 8 mg (n= 56). We calculated the relative risk (RR) for a serious adverse event in patients with and without systolic LVD.</p><p><strong>Results: </strong>LVEF was preserved in 84 (75.7%) of the patients with acute pulmonary edema. In patients with systolic LVD, 4 patients (26.9%) in the midazolam arm vs 6 (50%) in the morphine arm developed serious adverse events (RR, 0.53; 95% CI, 0.2-1.4). In patients without systolic LVD, 6 patients (15%) in the midazolam arm vs 18 (40.9%) in the morphine arm experienced such events (RR, 0.37; 95% CI, 0.16-0.83). The presence of systolic LVD did not modify the protective effect of midazolam on serious adverse effects (P=.57).</p><p><strong>Conclusion: </strong>The effect of midazolam vs morphine in protecting against the development of serious adverse events or death is similar in patients with and without systolic LVD.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9117182","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":"Screening for hidden human immunodeficiency virus infection in the emergency department: one hospital's experience.","authors":"Marta Del Palacio-Tamarit, Rodrigo Sanz-Lorente, Beatriz Álvarez-Álvarez, Alfonso Cabello-Úbeda, Joaquín García-Cañete, Antonio Blanco-García","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"35 1","pages":"74-75"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9457211","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":"Does education and training to prevent workplace aggression directed toward healthcare workers truly not reduce such aggressions?","authors":"Sonia Marías Pérez","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"486"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9075606","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":"Sociodemographic characteristics, functional status, and health resource use of older patients treated in Spanish emergency departments: a description of the EDEN cohort.","authors":"Òscar Miró,&nbsp;Javier Jacob,&nbsp;Eric Jorge García-Lamberechts,&nbsp;Pascual Piñera Salmerón,&nbsp;Pere Llorens,&nbsp;Sònia Jiménez,&nbsp;Guillermo Burillo-Putze,&nbsp;Francisco Javier Montero-Pérez,&nbsp;Sira Aguiló,&nbsp;Adriana Gil-Rodrigo,&nbsp;Cesáreo Fernández Alonso,&nbsp;Aitor Alquézar-Arbé,&nbsp;Patricia Parra-Esquivel,&nbsp;María José Fortuny Bayarri,&nbsp;Matilde González Tejera,&nbsp;Javier Millán Soria,&nbsp;Isabel Cirera,&nbsp;María Adroher,&nbsp;Enrique Martín Mojarro,&nbsp;Esther Gargallo García,&nbsp;Beatriz Valle,&nbsp;Ángel Díaz Salado,&nbsp;Martín Ruiz Grispán,&nbsp;María Pilar López Díez,&nbsp;Fahd Beddar Chaib,&nbsp;Manuel Salido Mota,&nbsp;Jorge Pedraza García,&nbsp;Gorreti Sánchez Sindín,&nbsp;Ricardo Juárez González,&nbsp;Rafael A Pérez Costa,&nbsp;Carmen Escudero Sánchez,&nbsp;Azucena Prieto Zapico,&nbsp;Juan González Del Castillo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the sociodemographic characteristics of and the health care resources used to treat patients aged 65 years or older who come to hospital emergency departments (EDs) in Spain, according to age groups.</p><p><strong>Material and methods: </strong>We studied the phase-1 data for the EDEN cohort (Emergency Department and Elder Needs). Forty Spanish EDs collected data on all patients aged 65 years or older who were treated on the first 7 days in April 2019. We registered information on 6 sociodemographic and 5 function variables for all patients. For health resource use we used 6 diagnostic, 13 therapeutic, and 5 physical structural variables, for a total of 24 variables. Differences were analyzed according to age in blocks of 5 years.</p><p><strong>Results: </strong>A total of 18 374 patients with a median age of 78 years were included; 55% were women. Twenty-seven percent arrived by ambulance, 71% had not previously been seen by a physician, and 13% lived alone without assistance. Ten percent had a high level of functional dependence, and 14% had serious comorbidity. Resources used most often were blood analysis (in 60%) and radiology (59%), analgesics (25%), intravenous fluids (21%), antibiotics (14%), oxygen (13%), and bronchodilators (11%). Twenty-six percent were kept under observation in the ED, 26% were admitted to wards, and 2% were admitted to intensive care units (ICUs). The median stay in the ED was 3.5 hours, and the median hospital stay was 7 days. Sociodemographic characteristics changed according to age. Functional dependence worsened with age, and resource requirements increased in general. However, benzodiazepine use was unaffected, while the use of nonsteroidal anti-inflammatory drugs and ICU admission decreased.</p><p><strong>Conclusion: </strong>The functional dependence of older patients coming to EDs increases with age and is associated with a high level of health care resource use, which also increases with age. Planners should take into consideration the characteristics of the older patients and the proportion of the caseload they represent when arranging physical spaces and designing processes for a specific ED.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"418-427"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091267","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":"Systemic corticosteroids for the treatment of COVID-19.","authors":"Carina Wagner,&nbsp;Mirko Griesel,&nbsp;Agata Mikolajewska,&nbsp;Anika Mueller,&nbsp;Monika Nothacker,&nbsp;Karoline Kley,&nbsp;Maria-Inti Metzendorf,&nbsp;Anna-Lena Fischer,&nbsp;Marco Kopp,&nbsp;Miriam Stegemann,&nbsp;Nicole Skoetz,&nbsp;Falk Fichtner","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"468-470"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091274","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":"Factors associated with short-term mortality after emergency department care of residents living in aged care homes: findings from the multicenter Caregency study.","authors":"F Javier Afonso-Argilés,&nbsp;Mercè Comas Serrano,&nbsp;Marta Blázquez-Andión,&nbsp;Xavier Castells Oliveres,&nbsp;Isabel Cirera Lorenzo,&nbsp;Dolors García Pérez,&nbsp;J María Gómez Roldán,&nbsp;Teresa Pujadas Lafarga,&nbsp;Xavier Ichart Tomás,&nbsp;Mireia Puig-Campmany,&nbsp;Miguel A Rizzi,&nbsp;Alba Sinfreu Pujol,&nbsp;Isabel Tejero Cano,&nbsp;Ana B Vena Martínez,&nbsp;Héctor Villanueva Sánchez,&nbsp;Anna Renom-Guiteras","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate short-term mortality in people transferred from aged care homes for treatment in a hospital emergency department (ED) and to analyze factors associated with mortality.</p><p><strong>Material and methods: </strong>Multicenter study of a random sample of retrospective data of patients treated in 5 EDs in Catalonia in 2017. The patients were over the age of 65 years and lived in residential care facilities. In addition to short-term mortality (in the ED or within 30 days of discharge), we analyzed sociodemographic characteristics, prior functional and cognitive status, multimorbidity, triage level on arrival, length of stay in the ED, and hospital admission. Odds ratios (ORs) for factors associated with short-term mortality were calculated by multivariate regression analysis.</p><p><strong>Results: </strong>A total of 2444 ED admissions were analyzed. The patients' mean (SD) age was 85.9 (7.1) years, and 67.7% .were women. Short-term mortality (in 15.5%) was associated with age >90 years (OR, 1.50; 95% CI, 1.5-1.95 years), a Charlson index >2 (OR, 1.47; 95% CI, 1.14-1.90), and dependency assessed as moderate (OR, 1.50; 95% CI, 1.03- 2.20) or severe (OR, 2.56; 95% CI, 1.84-3.55). Other associated factors were a higher level of urgency on triage, duration of ED stay, and hospital admission.</p><p><strong>Conclusion: </strong>Aged residents with the characteristics associated with short-term mortality could benefit from\u0000interventions for potentially avoiding unnecessary transfers to an ED, and from the implementation of comprehensive geriatric care within the ED. This could be useful to support good quality of care at the end of life.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"437-443"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9460210","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":"Intentional mass-casualty incidents with civil society targets in Europe a descriptive analysis for 2000 to 2018.","authors":"Eva M ª Valiño,&nbsp;Pedro Castro,&nbsp;Rafael Castro Delgado","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the main characteristics of intentional mass-casualty incidents (MCIs) with civil society targets in Europe between 2000 and 2018.</p><p><strong>Material and methods: </strong>Retrospective, descriptive analysis of intentional MCIs in Europe between 2000 and 2018 recorded in the Global Terrorism Database. We collected information on country; year; main and secondary weapons used and mainweapon subtype; numbers of attackers, victims, and points of attack; targets; and type of location.</p><p><strong>Results: </strong>A total of 469 points of attack were identified in 373 independent intentional MCIs (86% with multiple points of focus) that caused 15 066 victims (11 410 persons injured, 3656 deaths). The year with the most MCIs was 2014 (58 MCIs), and Russia saw the largest percentage (50.1%). Spain ranked third, with 8.7% of the MCIs in Europe, the highest proportion in Western Europe. Explosive devices were the weapons used most often (in 71.4%), followed by firearms (in 19.6%), and motor vehicles (in 2.6%). Vehicles, which use has been on the rise, caused the most injuries, with a median (interquartile range) of 19 (12-59) victims per intentional MCI (P = .026). The number of attackers in MCIs involving firearms correlated positively with the number of victims (r = 0.357, P = .011). The most frequent target was the civil population (in 53.1%), and public spaces and thoroughfares were the locations most often chosen (in 24.3%).</p><p><strong>Conclusion: </strong>Nearly 500 intentional MCIs have occurred in Europe in this XXI century. Most involved explosives or firearms. However, motor vehicles are the most potentially harmful weapons, and their use is increasing. These data may help to improve MCI emergency response planning.</p>","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"458-464"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9460211","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":"A history of cardiopulmonary resuscitation from the Book of Kings to Peter Safar - and of a woman drowned in the Seine along the way.","authors":"Enrique Chicote Álvarez,&nbsp;Natalia-Gloria Lizama-Gómez","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"478-480"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091277","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":"On older persons living in residential facilities and their care in emergency health services.","authors":"Cesáreo Fernández Alonso","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"411-412"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091266","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":"EDEN - the Emergency Department and Elder Needs project - is a chance to understand and improve a whole-system approach to elder care in Spanish emergency departments.","authors":"F Javier Martín-Sánchez,&nbsp;Cristina Bermejo Boixareu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":11644,"journal":{"name":"Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias","volume":"34 6","pages":"409-410"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091269","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}