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Use of telehealth and outcomes before a visit to the emergency department: a cross-sectional study on walk-in patients in Switzerland

Original article
Mettler AC, Piazza L, Michel J, Müller M, Exadaktylos AK, Hautz WE, Sauter TC
Swiss Med Wkly. 2021;151:w20543

An increasing number of patients are using telehealth before contacting the healthcare system. If we are to optimise future telehealth strategies and adequately respond to patient needs, we need to know more about the frequency and characteristics of telehealth use. The  objectives of this study were (i) to investigate whether patients use telehealth before consulting the emergency department (ED), (ii) to compare patients with and without use of telehealth, and (iii) to investigate adherence, confidence and satisfaction.

Impact of cardiopulmonary resuscitation on organ donation in Switzerland

Original article
Gottschalk M, Elmer A, Benden C, Beyeler F, Immer F
Swiss Med Wkly. 2021;151:w20413

This study reveals that a substantial proprotion of deceased organ donors in Switzerland underwent CPR in context of their hospitalisation. CPR donors are different from non-CPR donors with respect to age, cause of death and donation type. However, when carefully selected according to their haemodynamic condition, donor and organ utilisation and average organ yield, CPR donors are comparable to non-CPR donors. Thus, all patients who are resuscitated from cardiac arrest but who subsequently progress to death should be evaluated for organ donation. How CPR donors compare with non-CPR donors regarding transplant outcomes should be studied further.

Retrospective analysis of adverse drug reactions leading to short-term emergency hospital readmission

Original article
Banholzer S, Dunkelmann L, Haschke M, Derungs A, Exadaktylos A, Krähenbühl S, Liakoni E
Swiss Med Wkly. 2021;151:w20400

ADR-related readmissions constituted a considerable part of short-term emergency readmissions. Despite being a relevant cause for rehospitalisation, only a minority of the ADRs were reported to the regulatory authorities. 

Impact of the COVID-19 pandemic on acute coronary syndromes

Original article
Perrin N, Iglesias JF, Rey F, Benzakour L, Cimci M, Noble S, Degrauwe S, Tessitore E, Mach F, Roffi M
Swiss Med Wkly. 2020;150:w20448

Prolonged delays from symptom onset to first medical contact and a decline in overall ACS incidence were observed during the first wave of the COVID-19 pandemic, with a higher threshold to call for help among ACS patients.

Ultrasound-guided regional anaesthesia and reduction of distal radius fractures in an emergency department

Original article
Ammann S, Schoell E, Nieves Ortega R, Bingisser R
Swiss Med Wkly. 2020;150:w20288

The combination of ultrasound-guided regional anaesthesia and ultrasound-guided reduction of distal radius fractures is feasible.  Effectiveness regarding the necessity of subsequent operation was comparable to usual care.

Communication challenges in end-of-life decisions

Review article: Biomedical intelligence
Becker C, Beck K, Vincent A, Hunziker S
Swiss Med Wkly. 2020;150:w20351

With the progress in healthcare over recent decades and a growing life expectancy, discussions and decisions regarding end-of-life issues have become increasingly important. Especially in intensive care and emergency medicine there is a growing need of decision making for optimised end-of-life care. Prolonging life and preventing death is considered to be the highest principle of healthcare professionals; however, in some cases alleviation of suffering is a more appropriate goal. This article discusses communication challenges in end-of-life decision making and outlines strategies from an area of growing interest and research.

Value of the TTM risk score for early prognostication of comatose patients after out-of-hospital cardiac arrest in a Swiss university hospital

Original article
Kägi E, Weck A, Iten M, Levis A, Haenggi M
Swiss Med Wkly. 2020;150:w20344

Since the TTM followed strict inclusion and exclusion criteria, the validity in a general ICU population of cardiac arrest patients is unknown. With this study, the authors aimed to confirm and assess the usefulness in a Swiss population suffering from out-of-hospital cardiac arrest outside a clinical trial.

Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality – a retrospective study from a Swiss university hospital

Original article
Hautz WE, Sauter TC, Exadakytlos AK, Krummrey G, Schauber S, Müller M
Swiss Med Wkly. 2020;150:w20331

Barriers to seeking emergency care during the COVID-19 pandemic may lead to higher morbidity and mortality. Healthcare authorities and hospitals must ensure low barriers to treatment and business as usual for patients with chronic or acute on chronic illnesses.

Age, comorbidity, frailty status: effects on disposition and resource allocation during the COVID-19 pandemic

Nickel CH, Rueegg M, Pargger H, Bingisser R
Swiss Med Wkly. 2020;150:w20269

Three aspects are of utmost importance: first, determination of frailty status (and not just the patient’s age), second, balancing of benefits and harms while considering the most likely outcome taking comorbidity into account, and third, shared decision-making focusing on the individual’s goals of care.

Pain – the fifth vital sign

Christ M
Swiss Med Wkly. 2020;150:w20215

An encouraging article recently published in Swiss Medical Weekly reported that that the fundamental basis of adequate pain management is available in almost all Swiss emergency departments. What could be valuable next steps for excellent pain management within EDs?

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