Management Of Medical Emergencies Research Articles

Effects of deferment of clinic visit on cardiovascular outcomes during COVID-19 outbreak: a prospective cohort study

Abstract Background Current guidelines recommend 3-6 months interval outpatient follow-up for patients with cardiovascular (CV) diseases and risk factors such as hypertension, diabetes mellitus (DM) and dyslipidemia. The impact of longer follow-up intervals is unclear. From 2020 to 2022, due to the infection control measures for COVID-19 pandemic, many patients voluntarily deferred their scheduled clinic visits. This provided us with an opportunity to study the impact of prolonged visit intervals on management CV risk factors. Purpose We aimed to investigate the impact of prolonged clinic visit intervals on CV outcomes and CV risk factor management among patients with CV diseases. Methods Patients with at least 1 CV risk factor (DM, hypertension, dyslipidemia, or a history of CV disease) were recruited from cardiology outpatient clinics from a tertiary teaching hospital from 2020-2022. Patients who opted to defer their appointment (Deferred group) were compared to those who attended their scheduled appointment (Normal group). The primary outcomes were composite major adverse cardiovascular events (MACE) of myocardial infarction, stroke, or CV-related death. The secondary outcomes were any unscheduled hospitalizations, suboptimal DM control (haemoglobin A1C >7%) or hyperlipidemia (LDL > 1.4 mmol/L). Results Out of the 455 patients recruited from outpatient clinics, 162 patients (35.6%) opted to defer their scheduled clinic visit (mean age 64.7 ± 12, 37.7% female), and 293 patients (mean age 64.5 ± 10, 36.2% female) continued to attend their appointments. The mean appointment interval was 226 days for the normal group and 582 days for the deferred group (p< 0.001). There was no significant difference in the primary outcome of MACE between the ‘Normal’ group and the ‘Deferred’ group (2.5% vs 0.6%, p=NS). The number of patients with suboptimal DM control (11.4% vs 21.9%, p = 0.029) was higher in the deferred group, whereas suboptimal hyperlipidemia (73.1% vs 77.1%, p=NS) was not statistically different. There were a total of 27 of unscheduled hospitalizations, among which the majority was for CV-related events (63.0%). Patients in the ‘Deferred’ group had higher rates of unscheduled hospitalization (12.3% vs 2.4%, p < 0.001) and higher rate of CV-related hospitalization compared to the ‘Normal’ group (6.2% vs 2.4%, p=0.041). Conclusion Our prospective data demonstrates that a prolonged clinic visit interval of more than 365 days was not associated with significant increase in adverse CV event or worsening of lipid control. However, prolonged clinic visit interval was associated with worse DM control and more frequent unscheduled hospitalization. More frequent medical contact might allow timely management of medical emergency at the outpatient setting and contribute to the lower rate of hospitalization in the routine follow-up group.

Emergency medical supply planning considering prepositioning and dynamic in-kind donation management in healthcare coalitions.

This study tackles an integrated emergency medical supply planning problem, which incorporates supply prepositioning and dynamic in-kind donation management in healthcare coalitions. Although this problem is vital for field practice, it is not investigated in the existing emergency supply planning literature. To fill the gap, we propose a two-stage stochastic programming model, which facilitates the planning of emergency medical supply prepositioning before disasters and dynamic supply transshipment and in-kind donation solicitation and distribution after disasters. With a case study on the healthcare coalition of West China Hospital in Sichuan Province of China under the background of the COVID-19 epidemic, the proposed model and seven comparison models are optimally solved to show the effectiveness and benefits of our model. We conduct sensitivity analysis to generate managerial insights and policy suggestions for better emergency medical supply management practices in healthcarecoalitions.

The effect of acceptance and commitment therapy on work-related rumination and job fatigue of medical emergency and accident management center staff: an experimental study

BackgroundWorking in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran.MethodsThis study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis.ResultsThe findings showed that the average job fatigue reached 16.78\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\:\\pm\\:$$\\end{document} 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue.ConclusionTreatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel’s mental health and the quality of services provided to patients.Clinical trial numberNot applicable.

The Influencing Mechanism of Robustness of Emergency Medical Logistics: Mediating Role of Knowledge Integration

Drawing on the social capital theory, the research examines the impact of network size, network centrality, trust, and regulation on the knowledge integration and robustness of emergency medical logistics. Additionally, the research seeks to provide deeper insight into the link between the variables by studying how knowledge integration mediates the relationship between independent variables and the robustness of emergency medical logistics. The study utilized structural equation modeling to assess the underlying assumptions of the research model. A total of 465 valid questionnaires were collected from government departments, hospitals, social teams, and enterprises. The data processing and analysis were conducted using SPSS 23.0 and AMOS 24.0 software. The study’s outcome indicated that network size and network centrality have indirect effects on the robustness of emergency medical logistics through the intermediate variable of knowledge integration, but neither has a direct effect. Moreover, knowledge integration has a significant positive impact on the robustness of emergency medical logistics. Both trust and regulation have positive effects on the robustness of emergency medical logistics, and they also have positive effects on the robustness of emergency medical logistics through knowledge integration. This study is the inaugural exploration of the correlation between knowledge integration and the robustness of emergency medical logistics. It adds to the literature by providing evidence that knowledge integration is an essential emergency organization’s aide in promoting the robustness of emergency medical logistics. The findings of this study establish a strong theoretical foundation and practical significance for ensuring and improving the level of effectiveness in emergency medical logistics management.

Management of Medical Emergencies in Dental Office - A Review Article

Effective management of medical emergencies in a dental office is crucial for ensuring patient safety and maintaining a high standard of care. The importance of pre-emptive preparation, including staff training, emergency equipment availability and clear action plans is emphasized. The integrity of patient’s medical history and risk assessments into routine practice is a preventive measure to mitigate the likelihood of emergencies. By fostering a proactive approach to emergency management, dental offices can enhance patient safety and improve outcomes in critical situations. Keywords: Dental offices, medical emergencies, Risk assessment and management.

Medical Resource Management in Emergency Hierarchical Diagnosis and Treatment Systems: A Research Framework.

The occurrence of major public health crises, like the COVID-19 epidemic, present significant challenges to healthcare systems and the management of emergency medical resources worldwide. This study, by examining the practices of emergency medical resource management in select countries during the COVID-19 epidemic, and reviewing the relevant literature, finds that emergency hierarchical diagnosis and treatment systems (EHDTSs) play a crucial role in managing emergency resources effectively. To address key issues of emergency resource management in EHDTSs, we examine the features of EHDTSs and develop a research framework for emergency resource management in EHDTSs, especially focusing on the management of emergency medical personnel and medical supplies during evolving epidemics. The research framework identifies key issues of emergency medical resource management in EHDTSs, including the sharing and scheduling of emergency medical supplies, the establishment and sharing of emergency medical supply warehouses, and the integrated dispatch of emergency medical personnel. The proposed framework not only offers insights for future research but also can facilitate better emergency medical resource management in EHDTSs during major public health emergencies.

How aware are we about doping in sports? : A cross-sectional pilot survey of doctors

BackgroundDoctors lack the required anti-doping knowledge. The aim of this single-centre pilot study is to survey the awareness level of doctors about anti-doping regulations and their opinion with reasons on inclusion of sports pharmacology/anti-doping aspects in undergraduate medical curriculum. MethodsAfter ethical clearance, a cross-sectional online pilot survey was done among medical doctors on anti-doping aspects, general awareness, practical applications and opinion on inclusion of doping in sports as a competency under undergraduate medical curriculum. Responses were categorized and analysed. The significance was set at 0.05. Results80 doctors including 53 medicine and allied residents, 16 surgery and allied residents and 11 medical doctors took part in the study. 94% doctors understood about doping, 53% were aware about anti-doping organisation, 37% on regulations and 64% were right on prohibited list substances. 80% drugs of abuse mentioned clustered under only four categories (S1, S2, S5 and S6) of the World anti-doping agency (WADA) prohibited list. Practical sports specific anti-doping knowledge in weight cutting (97%), retroactive therapeutic use exemption of medical emergency management (0%), anti-asthmatic medication use (59%) and alcohol use (41%) were significant. Internet (67%) and newspaper (20%) were the main source of information. 73% doctors recommended inclusion of doping in sports in MBBS competency-based medical education (CBME) curriculum. ConclusionAnti-doping specific awareness and knowledge was found lacking among doctors. 73% doctors favour inclusion of doping in sport as a competency in the undergraduate medical curriculum to aid in better clinical practice and athlete counselling.

Collaboration between the French TMAS and CRAPEM on the management of psychiatric emergencies at sea

Doctors at the French Telemedical Assistance Service (TMAS) provide support to ship captains via teleconsultation for the management of medical emergencies during navigation. In response to this emerging demand for psychological or psychiatric care, TMAS doctors have been calling as and when required on a specialised platform known as the Resource Center for Psychological Assistance at Sea (CRAPEM), based in Saint Nazaire, France, since 2020. The study objective was to compare the management of psychiatric emergencies at sea by TMAS doctors alone versus TMAS doctors assisted by CRAPEM. We conducted a retrospective, descriptive epidemiological study between 1 January 2020 and 31 December 2021. We extracted data from AppliCCMM on patient characteristics, ship characteristics, management characteristics including final decision (treatment on board, disembarkation, diversion, evacuation or death) from previously identified diagnostic coding. Decisions were compared for “case” versus “control” using Chi-2 tests. Differences were considered significant if the P value was below 0.05. The analysis therefore focused on 21 patient cases and 63 patient controls. A comparison of the final decisions shows that patients in the CRAPEM group receive significantly (p < 0.001) less treatment on board. This difference is probably related to the fact that the patients for whom TMAS doctors seek advice from CRAPEM have more serious conditions. CRAPEM is a new organization aimed at improving the management of psychiatric illnesses in seafarers and, in our case, acute-phase psychological and psychiatric emergencies. Given the specific characteristics of the maritime environment, its intervention improves the management of patients at sea.

February 6th, Kahramanmaraş earthquakes and the disaster management algorithm of adult emergency medicine in Turkey: An experience review.

This compilation covers emergency medical management lessons from the February 6th Kahramanmaraş earthquakes. The objective is to review relevant literature on emergency services patient management, focusing on Koenig's 1996 Simple Triage and Rapid Treatment (START) and Secondary Assessment of Victim Endpoint (SAVE) frameworks. Establishing a comprehensive seismic and mass casualty incident (MCI) protocol chain is the goal. The prehospital phase of seismic MCIs treats hypovolemia and gets patients to the nearest hospital. START-A plans to expedite emergency patient triage and pain management. The SAVE algorithm is crucial for the emergency patient secondary assessment. It advises using Glasgow Coma Scale, Mangled Extremity Severity Score, Burn Triage Score, and Safe Quake Score for admission, surgery, transfer, discharge, and outcomes. This compilation emphasizes the importance of using diagnostic tools like bedside blood gas analyzers and ultrasound devices during the assessment process, drawing from 6 February earthquake research. The findings create a solid framework for improving emergency medical response strategies, making them applicable in similar situations.

Mortality Trends in Chest-Abdominal Trauma Patients Before and After the Establishment of Trauma Centers in South Korea

Purpose: We sought to assess mortality trends in chest-abdominal trauma patients, before and after the implementation of the Project Supporting Establishment of Trauma Centers (PSETC) in the Republic of Korea.Methods: Data from the National Health Insurance Service claims database between 2009 to 2017 were analyzed. Patients with chest-abdominal trauma were defined as those with relevant main diagnosis codes and claims for emergency medical management fees. Mortality and cumulative data were analyzed for each year to compare mortality before and after the establishment of regional trauma centers across Korea (2014).Results: In total, 29,127 patients were included in the analysis. While the annual incidence of trauma-related chest-abdominal injuries increased, mortalities decreased. In particular, the trauma incidence rate among patients over 50 years increased during the study period. Mortalities at trauma centers did not change year by year after the PSETC. Before and after 2014, when trauma centers operated under the PSETC, mortalities decreased [trauma cases before the PSETC; &lt;i&gt;n&lt;/i&gt; = 14,321 (mortality 5.61), after the PSETC; &lt;i&gt;n&lt;/i&gt; = 14,806 (mortality 4.96)].Conclusion: The number of patients treated for chest-abdominal injuries increased from 2009 to 2017 in Korea, whereas mortalities decreased over the same period.

MEDICAL EMERGENCIES PREPAREDNESS IN DENTAL CLINIC AMONG POSTGRADUATE RESIDENTS IN NEPAL

Background: Serious medical emergencies in dental practices are generally rare (one in 3-5 years) but if it happens it is life threatening to the patient. Adequate knowledge and competency, training of the dental practitioners is necessary to avoid such life-threatening conditions. The study was conducted to assess the preparedness of medical emergencies among postgraduate dental students of Nepal. Methods: An online questionnaire based cross-sectional study was conducted among all post graduate dental students from all the dental colleges of Nepal. Pretested, validated, close ended questionnaire was used. Questionnaire consisted of twenty medical emergency situations and five questions regarding self-evaluation of training regarding the management of medical emergencies. Chi-square test was used to assess association between competency in managing medical emergency situations and years of academic experience during post-graduation. P- value &lt;0.05 was considered statistically significant. Results: More than 70% participants answered correct management of medical emergency situations. Almost 20% disagreed and 20% don’t know about the management of such situations. Only 28% received training in the management of medical emergencies during undergraduate dental program. More than 50% were moderately satisfied with their knowledge about medical emergencies. Conclusions: The results of the study showed that knowledge to handle commonly occurring medical emergencies was higher. Most of the participants did not attend any training regarding medical emergencies. And those who attended felt there is need for further training in the management of emergency medical cases in the dental chair.

Medical Emergency Response and Management of Tritium-Related Accidents

Medical Emergency Response and Management of Tritium-Related Accidents

Simulation training for medical emergencies: Evaluation of dentists' long-term learning skills and confidence.

As the population ages and more patients experience medical emergencies during dental treatments, dentists must competently and confidently manage these situations. We developed a simulation training course for medical emergencies in the dental setting using an inexpensive vital sign simulation app for smartphones/tablets without the need for an expensive simulator. However, the duration for which this effect is maintained is unclear. This study was performed to evaluate the long-term educational effect at 3, 6, and 12 months after taking the course. Thirty-nine dental residents participated in this course. Scenarios included vasovagal syncope, anaphylaxis, hyperventilation syndrome, and acute coronary syndrome, each of which the participants had to diagnose and treat. The participants were evaluated using a checklist for anaphylaxis diagnosis and treatment skills immediately after and 3, 6, and 12 months after the course. The participants were also surveyed about their confidence in diagnosing and treating these conditions by questionnaire before, immediately after, and 3, 6, and 12 months after the course. The checklist scores for anaphylaxis were significantly lower at 3, 6, and 12 months after the course than immediately after the course. The percentage of participants who provided a correct diagnosis and appropriate treatment for vasovagal syncope, hyperventilation syndrome, and acute coronary syndrome was lower at all reassessments than immediately after the course. Because medical emergency management skills and confidence declined within 3 months, it would be useful to introduce a refresher course approximately 3 months after the initial course to maintain skills and confidence.

Juvenile Systemic Lupus Erithemathosus And Dengue Fever: A Case Report

The clinical management of patients with systemic lupus erythematosus in emergency situations requires a thorough understanding of the clinical features and complications associated with this condition. The objective of this study is to report a clinical case of an individual with systemic lupus erythematosus undergoing treatment with azathioprine associated with dengue virus infection and severe clinical manifestations. The 27-year-old male patient developed fever, myalgia, and diarrhea eight days before admission, was admitted to the emergency room of a private hospital in São Paulo with clinical worsening associated with hypotension and drowsiness, and a sepsis protocol was opened, as evidenced in the initial laboratory tests of acute renal failure Kdigo III, hydroelectrolyte disorders, blood dyscrasias, pancytopenia, antibiotic therapy for septic shock, abdominal focus in the first hour, use of vasopressor drugs, and admitted to an intensive care bed. During hospitalization, a patient diagnosed with group D dengue and active systemic lupus erythematosus, presenting renal dysfunction requiring renal replacement therapy, liver failure, collection secondary to dengue virus infection, necrotizing pancreatitis, blood dyscrasias, respiratory failure, and alveolar hemorrhage secondary to capillaritis due to dengue or systemic lupus erythematosus, treated with broad-spectrum antibiotics, human immunoglobulin, corticosteroid therapy, however, despite all the therapeutic arsenal and advanced support, the patient progresses to death after 42 days of hospitalization. These situations pose significant challenges in the management of medical emergencies and endemic diseases, and therefore require a comprehensive understanding to ensure appropriate treatment and improved clinical outcomes.

Неотложная помощь при экстренных состояниях в диабетологии

Management of medical emergencies in diabetology is an essential area of interest for anesthesiology and intensive care medicine. The main complications of diabetes mellitus (DM) that require intensive treatment and pose a risk of death are hypoglycemia, diabetic ketoacidosis (DKA), and hyperosmolar hyperglycemic state (HHS). This paper provides an analysis of modern scientific publications devoted to clinical manifestations of hypoglycemia, DKA and HHS, and specific aspects of urgent care in these conditions. As demonstrated by data provided here, intensive therapy of these complications of DM is based on stabilization of blood glucose levels, administration of intravenous insulin in DKA and HHS, as well as infusion therapy and correction of electrolyte disturbances. This work discusses the main medications used for treatment of hypoglycemia, DKA and HHS, along with their dosing regimens and routes of administration. Emphasis is made on measures for prevention of cerebral edema, which the main complication associated with these conditions. Knowledge and strict adherence to therapeutic algorithms in medical emergencies in diabetology will help improve clinical outcomes, reduce the risk of complications and bring down death rates.

Pediatric Medical Countermeasures: Antidotes and Cytokines for Radiological and Nuclear Incidents and Terrorism.

The war in Ukraine raises concerns for potential hazards of radiological and nuclear incidents. Children are particularly vulnerable in these incidents and may need pharmaceutical countermeasures, including antidotes and cytokines. Searches found no published study comparing pediatric indications and dosing among standard references detailing pediatric medications for these incidents. This study addresses this gap by collecting, tabulating, and disseminating this information to healthcare professionals caring for children. Expert consensus chose the following references to compare their pediatric indications and dosing of medical countermeasures for radiation exposure and internal contamination with radioactive materials: Advanced Hazmat Life Support (AHLS) for Radiological Incidents and Terrorism, DailyMed, Internal Contamination Clinical Reference, Medical Aspects of Radiation Incidents, and Medical Management of Radiological Casualties, as well as Micromedex, POISINDEX, and Radiation Emergency Medical Management (REMM). This is the first study comparing pediatric indications and dosing for medical countermeasures among commonly used references for radiological and nuclear incidents.

Cerebral Mucormycosis without Rhino-Orbital Involvement in a Patient with Chronic Kidney Disease

Isolated cases of cerebral mucormycosis demand high clinical suspicion and prompt diagnosis and treatment. In the present case, the patient was a young diagnosed case of chronic kidney disease (CKD) for two years on maintenance hemodialysis, presented with symptoms of headache and increased intracranial pressure, which necessitated both emergency surgical and medical management and was both diagnosed and managed efficiently. Early recognition of clinical and radiological cues with early institution of a medico-surgical approach, with proper containment of underlying predisposing conditions, is vital for managing mucormycosis. The case elucidates that mucormycosis can present as an isolated cerebral abscess without rhino-orbital involvement. CKD should be considered as a possible immunocompromised state predisposing to mucormycosis.

The Role of Ventricular Assist Device Coordinator Nurse in Saudi Arabia

Background: The Ventricular Assist Device (VAD) Coordinator Nurse plays a vital role in managing patients with end-stage heart failure requiring mechanical circulatory support. However, limited research exists on the specific responsibilities and contributions of VAD coordinators, particularly in Saudi Arabia. Understanding their roles and impact on patient care and organizational outcomes is crucial for healthcare improvement. Objective: This study examined the role of VAD Coordinator Nurse in Saudi Arabia by describing the role characteristics, including demographic information, qualifications, compensation, job preparation, work setting and responsibilities, scope of practice, contributions to patient care, and organizational outcomes. Methods: A descriptive study was conducted to explore the roles of VAD Coordinator Nurses in Saudi Arabia. A survey instrument developed by Casida (2011) was used to collect data from VAD coordinators working in Saudi Arabian centers offering VAD services. Convenience sampling was employed, and the survey was distributed electronically through the hospital's email system. Descriptive statistics, including percentages and frequencies, were calculated using the Statistical Package for the Social Sciences (SPSS). Results: The study involved VAD coordinators with an average age of 36.47 years, predominantly male (60%), and Arab (80%). Most participants held a bachelor’s degree (60%) and had previous experience as staff nurses. Findings revealed that VAD Coordinator Nurses have diverse responsibilities, including patient monitoring, VAD performance evaluation, medical emergency management, and coordination of ancillary tasks. Conclusions: This study highlights the dynamic and multifaceted roles of VAD Coordinator Nurses in Saudi Arabia. They play a crucial role in bridging the technical and clinical aspects of VADs, ensuring optimal patient care, and contributing to positive organizational outcomes. Understanding their demographics, qualifications, responsibilities, and contributions is essential for healthcare policies and job preparation enhancements. Future research should address challenges faced by VAD coordinators and support their professional growth in delivering high-quality care to patients with end-stage heart failure.

Impact of Mobile Stroke Units on Patients With Large Vessel Occlusion Acute Ischemic Stroke: A Prespecified BEST‐MSU Substudy

Background The impact of mobile stroke units (MSUs) on outcomes in patients with large vessel occlusions eligible for endovascular thrombectomy (EVT) has yet to be characterized. Methods We completed a prespecified substudy of patients with EVT‐eligible stroke with anterior and posterior circulation large vessel occlusions on computed tomography and/or computed tomography angiography who were enrolled in BEST‐MSU (Benefits of Stroke Treatment using a Mobile Stroke Unit). Primary outcome was 90‐day utility‐weighted modified Rankin scale. Groups were compared using chi‐square or Fisher's exact tests for categorical variables, and 2‐sample t ‐tests for continuous variables. Multiple logistic regression was used to assess the effect of MSU on binary outcomes after adjusting for other baseline factors. Results Of 1515 trial patients, 293 had large vessel occlusions eligible for EVT: 168 in the MSU group and 125 in the emergency medical services group. Baseline characteristics were comparable, with the exception of baseline National Institutes of Health Stroke Scale score (MSU median 19 [interquartile range 13, 23] versus emergency medical services 16 [11, 20], P = 0.002) and study site. The mean (±SD) score on the utility‐weighted modified Rankin scale at 90 days was 0.63±0.39 in MSU group and 0.51±0.41 in emergency medical services group (mean difference 0.13, 95% CI [0.03–0.22]). After adjustment, MSU had significantly higher odds of functional independence (odds ratio 2.60 [95% CI, 1.45–4.77], P = 0.002). Secondary outcomes also favored MSU: early neurologic recovery (30% improvement in National Institutes of Health Stroke Scale score at 24 hours) 68% versus 52%; adjusted odds ratio 1.98 [95% CI, 1.19–3.33]; time of tissue plasminogen activator bolus from symptom onset 65.0 minutes [50.5–92.0] versus 96.0 [79.3–130.0], P ≤0.001. The groups had similar onset to arterial puncture (169.0 minutes [133.5, 210.0] versus 162.0 [135.0–207.0], P = 0.83). Conclusions In patients with EVT‐eligible large vessel occlusion stroke, MSU management was associated with better clinical outcomes compared with standard emergency medical services management. MSU management sped thrombolysis but did not expedite EVT treatment times. Future MSU processes should include efforts to capitalize on the potential of MSUs to provide earlier EVT.

A quality improvement project to improve the quality of medical emergency aide-mémoires.

Introduction Medical emergencies occur within the dental setting and we have a duty of care to manage them appropriately. Due to perceived anxiety in handling medical emergencies, aide-mémoires were developed to improve staff confidence in the management of these stressful situations.Methods A survey was carried out at The Royal London Dental Hospital to assess knowledge and experience in use of existing supportive materials for medical emergency management. New colour-coded flashcards were subsequently developed, providing guidance to identifying and managing medical emergencies. A questionnaire was produced assessing clinicians' awareness of existing prompts and preferences in relation to the new flashcards. Updated cards were incorporated into simulated medical emergency teaching and evaluated afterwards through a questionnaire.Results A total of 50 responses were gathered across departments to the questionnaire regarding preliminary flashcards: 95% favoured the flashcard approach and felt they would be more helpful managing medical emergencies. The new flashcards were used by 18 clinicians in medical emergency simulation and 17 (94%) felt that using the cards improved their confidence in the handling of medical emergencies.Discussion The flashcards have been perceived to be useful in the handling of medical emergencies within our dental hospital. A similar project may be beneficial to clinical teams working across dental settings.