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Level of Stress at Nurses Working in emergency Clinic and Central Intensive Care: University Clinical centre of Kosovo

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Open Journal of emergency Medicine 2020年第2期8卷 39-52页

作者： Elvana Podvorica Besnik Rrmoku Albulena Metaj Hasan Gashi Faculty of Medicine Department Nursing and Midwifery University of Pristina Pristina Kosovo Universi College Pristina Kosovo emergency Clinic University Clinical Centre of Kosova Prishtina Republic of Kosovo Faculty of Education University of Prishtina Prishtin&euml Kosovo Rezonanca College Pristina Kosovo

Background: emergency Clinic (EC) and Central Intensive Care (CIC) are high-stress environments that directly affect the health status of nurses. Methods: The aim of this study was to assess the level of stress at nurses working in the emergency Clinic and nurses working in the Central Intensive Care. The study included 90 nurses, 45 nurses working in emergency Clinic and 45 nurses working in Central Intensive Care. The study applied the emergency Nurse Stress Questionnaire as an instrument to gather the data. This questionnaire was adopted from the Operational Police Stress Questionnaire in order to serve for the function and aim of the present study. Results: Nurses’ cohort-age ranged from 20 to 62 years. The largest proportion of respondents 40 (44.4%) was in the 20 - 30 age group, 58 (64.4%) were married, 60 (66.6%) hold bachelor degree and (33.3%) were with secondary school educational level. In terms of work-related fatigue, significant difference was found in working hours, participants reported that there was a significant difference in fatigue between 12 hours shift nurses (61 ± 10.5) compared to 8 hours nurses (41 ± 23.6) with P Conclusion: These findings emphasize the role of using and assuring adequate strategies for ensuring quality management and finding ways of facilitating the increase in the number of nursing staff in these two departments because workplace overload and fatigue are potential factors that increase nurses’ stress levels.

关键词： emergency Clinic Central Intensive Care Nurses Workplace Stress Fatigue

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Use of Standard Operating Procedures for Supporting Cross-Organizational emergency Management: Challenges and Opportunities Identified from a Tabletop Exercise

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International Journal of Disaster Risk Science 2024年第05期15卷 673-687页

作者： Kristine Steen-Tveit Bj?rn Erik Munkvold Kjetil Rustenberg Department of Information Systems Centre for Integrated Emergency ManagementUniversity of Agder

This study investigated the crucial role of formulating and applying standard operating procedures(SOPs) in the context of emergency planning and response. The effective application of SOPs during operations is essential in order to address challenges that surpass individual organizational capacities. A specific focus on fostering efficient information sharing and executing specified actions maximizes the prospect of success. To explore the collective functionality of SOPs across organizations, we conducted a comprehensive tabletop exercise involving 10 organizations spanning tactical, operational,and strategic levels. Our analysis identified six key challenges, primarily related to the structures for information sharing,communication pathways, and the complex integration and application of common SOPs within these diverse organizational contexts. This research contributes insights into the use of SOPs in large-scale, cross-organizational scenarios.

关键词： Cross-organizational emergency management Standard operating procedures Tabletop exercise Team situational awareness

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Venous thromboembolism in the emergency department:A survey of current best practice awareness in physicians and nurses in China

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World Journal of emergency Medicine 2019年第1期10卷 5-13页

作者： Wen-hua Zhou Jian-qiang He Shi-gong Guo Joseph Walline Xiao-ying Liu Li-yuan Tian Hua-dong Zhu Xue-zhong Yu Yi Li emergency Department Peking Union Medical College Hospital Oxford centre for Enablement Nuffi eld Orthopaedic Centre Accident and emergency Medicine Academic Unit Prince of Wales Hospital The Chinese University of Hong Kong

BACKGROUND: For emergency department(ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism(VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE. METHODS: We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 ***: In this survey, 180 questionnaires were distributed and 174 valid responses(response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no signifi cant differences were found with respect to job(doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years(n=83) scored signifi cantly higher on the questionnaire than those under 5 years(n=91)(95.75 vs. 79.97, P=0.039). There was a signifi cant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working ***: Our survey has shown defi ciencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events(including VTE).

关键词： emergency Venous thromboembolism Staff knowledge emergency doctor emergency nurse

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The impact of prehospital blood sampling on the emergency department process of patients with chest pain:a pragmatic non-randomized controlled trial

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World Journal of emergency Medicine 2023年第4期14卷 257-264页

作者： Johan L.van Nieuwkerk M.Christien van der Linden Rolf J.Verheul Merel van Loon-van Gaalen Marije Janmaat Naomi van der Linden emergency Department Haaglanden Medical Centre&Emergency Medical Services Haaglandenthe Hague 2501 CBthe Netherlands Research and Development Haaglanden Medical Centrethe Hague 2501 CKthe Netherlands Laboratory Services Haaglanden Medical Centrethe Hague 2501 CKthe Netherlands emergency Department Haaglanden Medical Centrethe Hague 2501 CKthe Netherlands Faculty of Health University of Applied Sciences LeidenLeiden 2300 AJthe Netherlands Faculty of Technology Policy and ManagementDelft University of TechnologyDelft 2628 BXthe Netherlands

BACKGROUND:In patients with chest pain who arrive at the emergency department(ED)by ambulance,venous access is frequently established prehospital,and could be utilized to sample *** blood sampling may save time in the diagnostic *** this study,the association of prehospital blood draw with blood sample arrival times,troponin turnaround times,and ED length of stay(LOS),number of blood sample mix-ups and blood sample quality were ***:The study was conducted from October 1,2019 to February 29,*** patients who were transported to the ED with acute chest pain with low suspicion for acute coronary syndrome(ACS),outcomes were compared between cases,in whom prehospital blood draw was performed,and controls,in whom blood was drawn at the *** analyses were used to assess the association of prehospital blood draw with the time ***:Prehospital blood draw was performed in 100 *** 406 patients,blood draw was performed at the *** blood draw was independently associated with shorter blood sample arrival times,shorter troponin turnaround times and decreased LOS(P0.05).CONCLUSION:For patients with acute chest pain with low suspicion for ACS,prehospital blood sampling is associated with shorter time intervals,while there were no significant differences between the two groups in the validity of the blood samples.

关键词： Blood specimen collection Crowding emergency medical services Troponin

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A rare co-occurrence of spontaneous pneumomediastinum,pneumothorax,and pneumoperitoneum:Macklin effect

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World Journal of emergency Medicine 2024年第3期15卷 246-248页

作者： Renaldo Pavrey Nikita Makwana Nisha Das centre for Accident and emergency Medicine Nanavati Max Super Specialty HospitalMumbai 400050India

Spontaneous pneumomediastinum (SPM) is characterized by free air or gas located within the mediastinum that is not associated with any noticeable cause,such as chest trauma,intrathoracic infections,surgery,other organ... 详细信息

关键词： rupture trauma infections

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Association between the elderly frequent attender to the emergency department and 30-day mortality： A retrospective study over 10 years

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World Journal of emergency Medicine 2018年第1期9卷 20-25页

作者： Yuzeng Shen Yee Chien Tay Edward Wee Kwan Too Nan Liu Shao Wei Lam Marcus Eng Hock Ong Department of emergency Medicine Singapore General Hospital Singapore Department of emergency Medicine Sengkang Health Singapore Business Analytics Program National University of Singapore Singapore Singhealth Health Selvices Research centre Singapore

BACKGROUND: To determine if elderly frequent attenders are associated with increased 30-day mortality, assess resource utilization by the elderly frequent attenders and identify associated characteristics that contribute to mortality. METHODS: Retrospective observational study of electronic clinical records of all emergency department(ED) visits over a 10-year period to an urban tertiary general hospital in Singapore. Patients aged 65 years and older, with 3 or more visits within a calendar year were identified. Outcomes measured include 30-day mortality, admission rate, admission diagnosis and duration spent at ED. Chi-square-tests were used to assess categorical factors and Student t-test was used to assess continuous variables on their association with being a frequent attender. Univariate and multivariate logistic regressions were conducted on all significant independent factors on to the outcome variable(30-day mortality), to determine factor independent odds ratios of being a frequent ***: 1.381 million attendance records were analyzed. Elderly patients accounted for 25.5% of all attendances, of which 31.3% are frequent attenders. Their 30-day mortality rate increased from 4.0% in the first visit, to 8.8% in the third visit, peaking at 10.2% in the sixth visit. Factors associated with mortality include patients with neoplasms, ambulance utilization, male gender and having attended the ED the previous ***: Elderly attenders have a higher 30-day mortality risk compared to the overall ED population, with mortality risk more marked for frequent attenders. This study illustrates the importance and need for interventions to address frequent ED visits by the elderly, especially in an aging society.

关键词： Frequent attenders Elderly emergency department Mortality

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End-tidal capnometry during emergency department procedural sedation and analgesia： a randomized, controlled study

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World Journal of emergency Medicine 2016年第1期7卷 13-18页

作者： Samuel G. Campbell Kirk D. Magee Peter J. Zed Patrick Froese Glenn Etsell Alan LaPierre Donna Warren Robert R. MacKinley Michael B. Butler George Kovacs David A. Petrie Department of emergency Medicine and Anesthesia Dalhousie University Halifax Nova Scotia Canada Faculty of Pharmaceutical Sciences and Department of emergency Medicine University of British Columbia Vancouver BC Canada Charles V. Keating emergency and Trauma centre Halifax Nova Scotia Canada Department of emergency Medicine Anesthesia and Anatomy Dalhousie University Halifax Nova Scotia Canada

BACKGROUND:This prospective,randomized trial was undertaken to evaluate the utility of adding end-tidal capnometry(ETC)to pulse oximetry(PO)in patients undergoing procedural sedation and analgesia(PSA)in the emergency department(ED).METHODS:The patients were randomized to monitoring with or without ETC in addition to the current standard of *** endpoints included respiratory adverse events,with secondary endpoints of level of sedation,hypotension,other PSA-related adverse events and patient ***:Of 986 patients,501 were randomized to usual care and 485 to additional ETC *** this series,48%of the patients were female,with a mean age of 46 *** manipulations(71%),cardioversion(12%)and abscess incision and drainage(12%)were the most common procedures,and propofol and fentanyl were the sedative/analgesic combination used for most *** was no difference in patients experiencing de-saturation(Sa O2<90%)between the two groups;however,patients in the ETC group were more likely to require airway repositioning(12.9%vs.9.3%,P=0.003).Hypotension(SBP<100 mm Hg or<85 mm Hg if baseline<100 mm Hg)was observed in 16(3.3%)patients in the ETC group and 7(1.4%)in the control group(P=0.048).CONCLUSIONS:The addition of ETC does not appear to change any clinically significant *** found an increased incidence of the use of airway repositioning maneuvers and hypotension in cases where ETC was *** do not believe that ETC should be recommended as a standard of care for the monitoring of patients undergoing PSA.

关键词： Procedural sedation and analgesia Capnography Adverse events emergency medicine

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Susceptibility Assessment of Landslides in Alpine-Canyon Region Using Multiple GIS-Based Models

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Wuhan University Journal of Natural Sciences 2019年第3期24卷 257-270页

作者： HU Man LIU Qiuqiang LIU Pengyu College of Engineering and Technology Southwest University Consultative centre for Geo-Hazard emergency Ministry of Land and Resources of China

This study explores a comparative study of three susceptibility assessment models based on remote sensing(RS) and geographic information system(GIS). The Lenggu region(China) was selected as a case study. At first, a landslide inventory map was compiled using data from existing geology reports, satellite imagery, and coupling with field observations. Subsequently, three models were built to map the landslide susceptibility using analytical hierarchy process(AHP), fuzzy logic(FL) and certainty factors(CF). The resulting models were validated and compared using areas under the curve(AUC). The AUC plot estimation results indicated that the three models are promising methods for landslide susceptibility mapping. Among the three methods, CF model has highest prediction accuracy than the other two models. Similarly, the outcome of this study reveals that streams, faults, slope and elevation are the main conditioning factors of landslides. Especially, the erosion of streams plays a key role of the landslide occurrence. These landslide susceptibility maps, to some extent, reflect spatial distribution characteristics of landslides in alpine-canyon region of southwest China, and can be used for land planning and hazard risk assessment.

关键词： landslide susceptibility assessment geographic information system (GIS) analytical hierarchy process (AHP) fuzzy logic(FL) certainty factors(CF)

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Multi-objective optimization of a flow straightener in a large capacity firefighting water cannon

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Journal of Hydrodynamics 2019年第1期31卷 137-144页

作者： Qing-jiang Xiang Lin Xue Kwang-Yong Kim Zhe-fu Shi National Research centre of Pumps Jiangsu UniversityZhenjiang 212013China Department of Mechanical Engineering Inha UniversityIncheonKorea Shanghai Fire Research Institute of Ministry of emergency Management Shanghai 200032China

In the present study,a multi-objective optimization of a flow straightener in a firefighting water cannon is performed by using the surrogate modeling and a hybrid multi-objective genetic algorithm to increase the jet range of the water *** on analysis using the three-dimensional Reynolds-averaged Navier-Stokes equations,the optimization is carried with a surrogate model and the radial basis neural *** geometric design variables,i.e.,the lengt扎 the thickness of the blade,and the radius of the outer pipe of the flow straightener,are selected for the *** pressure drop through the water can non and the area-averaged turbulent kinetic energy at the outlet of the water cannon,which are closely related to the jet range of the water cannon,are selected as the objective functions to be *** design space is determined through a parametric study,and the Latin hypercube sampling method is used to select the design points in the design *** Pareto-optimal solutions are obtained through the *** representative Pareto-optimal solutions are selected to study the trade-off between two objectives.

关键词： Firefighting water cannon multi-objective optimization surrogate model turbulence kinetic energy hydraulic loss

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The effects of hyperbaric oxygen therapy on paroxysmal sympathetic hyperactivity after cardiopulmonary resuscitation: a case series

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World Journal of emergency Medicine 2023年第6期14卷 477-480页

作者： Hongyu Wang Yihao Li Meng Zhao Caihong Ren Sisen Zhang Department of emergency Medicine the Fifth Clinical Medical College of Henan University of Chinese MedicineZhengzhou 450003China Department of emergency Medicine People's Hospital of Henan Universityof Chinese Medicine/People's Hospitalof ZhengzhouZhengzhou 450003China Henan Research centre of Cardiopulmonary-Cerebral Resuscitation Engineering Technology Zhengzhou 450003China Department of emergency Medicine Luohe Central HospitalLuohe 462000China

The onset of cardiac arrest (CA) is sudden and *** to cerebral ischaemia and hypoxia, the prognosis for post-cardiopulmonary resuscitation (CPR) patients is poor. Paroxysmal sympathetic hyperexcitability (PSH) is a potentially life-threatening condition, which is characterized by episodes of increased heart rate and blood pressure,sweating, hypothermia, and forced posture.[1] Hypoxicischaemic encephalopathy post-CPR can lead to PSH,which often indicates a worse prognosis.

关键词： sympathetic resuscitation prognosis

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