ABSTRACT
OBJECTIVES: As a part of the chain of survival, the emergency medical communication centre (EMCC) and the emergency medical dispatcher (EMD) has an important role in early identification of out-of-hospital cardiac arrests (OHCA). The EMD may provide instructions to the caller and thereby initiate cardiopulmonary resuscitation in a substantial number of subjects and thus contribute to increased survival. The EMCC provides a response with first responders, ambulances, physician manned units and potentially other health care providers. EMCC in many cases initiates the communication with experts in the referral hospital and provide added value to the post resuscitation care by providing advanced transport, logistics and follow up. In research there is a growing focus on the EMCC/EMDs impact on survival in OHCA. The lack of standards in reporting results from medical dispatching is an obstacle for thorough evaluation of results in this area and comparison of data. The objective for this paper is to introduce a framework for uniform reporting of the dispatching process for quality improvement, collecting and reporting data and exchanging information regarding OHCA.
Subject(s)
Cardiopulmonary Resuscitation/methods , Emergency Medical Service Communication Systems/standards , Out-of-Hospital Cardiac Arrest/diagnosis , Quality Improvement , Cardiopulmonary Resuscitation/standards , Humans , Out-of-Hospital Cardiac Arrest/therapyABSTRACT
OBJECTIVES: To establish a uniform framework describing the system and organisation of emergency medical response centres and the process of emergency medical dispatching (EMD) when reporting results from studies in emergency medicine and prehospital care. DESIGN AND RESULTS: In September 2005 a task force of 22 experts from 12 countries met in Stavanger; Norway at the Utstein Abbey to review data and establish a common terminology for medical dispatch centres including core and optional data to be used for health monitoring, benchmarking and future research.
Subject(s)
Emergency Medical Service Communication Systems/organization & administration , Emergency Medicine , Guidelines as Topic , Health Services Research/organization & administration , Humans , Research DesignABSTRACT
The authors describe a fatal case of a group A beta-haemolytic streptococci infection. The symptoms seemed to have been initiated by minor skin trauma; intramuscular injections of diclofenac (Voltaren) and metoclopramide (Primperan) after which the patient developed extensive muscle necrosis. The clinical course was rapid and he died within 48 hours after the first injection from circulatory collapse, probably due to overwhelming septicaemia with group A beta-haemolytic streptococci. Streptococcal myositis is a rare and extremely serious complication of skin trauma. Muscle necrosis is also a known but rare side effect of intramuscular administration of drugs (the "Nicolau syndrome") in which non-steroid anti-inflammatory drugs are often implicated. The case is discussed in the context of this specific syndrome.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Diclofenac/adverse effects , Muscles/pathology , Myositis/etiology , Streptococcal Infections/complications , Adult , Diclofenac/administration & dosage , Humans , Injections, Intramuscular , Male , NecrosisABSTRACT
We report a ten-year series of 18 patients treated for acute acalculous cholecystitis. 12 were males and six females, ranging in age from 23 to 77 years, with a mean of 64. 13 underwent major surgical procedures, two for multiple injuries. An additional four patients were also treated for multiple injuries. Clinical knowledge and a critical attitude are essential for the diagnosis. Blood tests are unreliable, since the result may be affected by other complications or associated diseases. It is therefore necessary to use diagnostic imaging. The treatment of choice is percutaneous bile drainage.
