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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

https://caltcm.memberclicks.net/assets/documents/acc_aha_chf_2013_guidelines.pdf

2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation

/pdf/2016-esc-guidelines-for-the-diagnosis-and-treatment-of-acute-z18hg30pp1.pdf

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation : The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC).

/pdf/2015-esc-guidelines-for-the-management-of-acute-coronary-6did6h5nxk.pdf

2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)

Chest pain centers (CPCs) started to develop in the United Kingdom (UK) in the late 1990s, based on research evidence from the United States (US). Development was prompted by familiar problems with routine chest pain care, such as inadvertent discharge of patients with acute coronary syndrome (ACS), variable use of diagnostic testing and inefficient use of resources. However, international differences in routine clinical practice and health care funding have created important differences in the development and evaluation of CPC care in the UK. This article describes the development of CPC care in the UK and highlights some key lessons from the process.

View from the United Kingdom: chest pain center progress.

/pdf/131utility-of-the-4at-rapid-assessment-instrument-in-2o0d3a8sul.pdf

131utility of the 4at rapid assessment instrument in assessment of delirium and cognitive impairment in acute care

Introduction and purpose The use of ambulance services by older patients with injuries increases within the impacts of ageing-related changes leading to adverse patient outcomes. There is increasing recognition of the importance of prehospital trauma care for older patients, but little systematic research to guide practice. We aimed to review the published evidence on prehospital trauma care for older patients, determine the scope of existing research and identify research gaps in the literature. Methods A systematic scoping review guided by the Arksey and O’Malley framework reported in line with the PRISMA-ScR checklist. A systematic search was conducted of Scopus, CINAHL, MEDLINE, PubMed and Cochrane library databases to identify articles published between (2001–2021) years. Inclusion and exclusion criteria were applied independently by two reviewers. Data were extracted, charted and summarised from eligible articles. Results 65 studies were identified and reviewed, and 25 included. Five categories were identified: ‘field triage, ‘ageing impacts’, ‘decision-making’, ‘paramedic’ awareness’ and ‘paramedic’s behaviour’. Undertriage & overtriage (sensitivity & specificity) were commonly cited as poorly investigated field-triage subthemes. Ageing-related physiologic changes, comorbidities and polypharmacy were the most widely researched. Inaccurate decision-making and poor early identification of major injuries were identified as potentially influencing patient outcomes. More research is required into paramedic knowledge of geriatric care & ageing changes and the potential impact of paramedic care. Conclusion This is the first study reviewing the published evidence on prehospital trauma care for older patients and identifying research priorities for future research. This review has identified the prehospital triage for older trauma victims and studies of paramedic knowledge of older trauma care as key priorities. Investigating and understanding these can improve providing prehospital care of the older patient with injuries for positive patient outcomes.

/pdf/research-priorities-for-prehospital-care-of-older-patients-66vwqynv.pdf

Research priorities for prehospital care of older patients with injuries: scoping review

Meta-analysis: The value of clinical assessment in the diagnosis of deep vein thrombosis

Background Alcohol intoxication management services (AIMS) provide an alternative care pathway for alcohol-intoxicated adults otherwise requiring emergency department (ED) services and at times of high incidence. We estimate the effectiveness and cost-effectiveness of AIMS on ED attendance rates with ED and ambulance service performance indicators as secondary outcomes. Methods A controlled longitudinal retrospective observational study in English and Welsh towns, six with AIMS and six without. Control and intervention cities were matched by sociodemographic characteristics. The primary outcome was ED attendance rate per night, secondary analyses explored hospital admission rates and ambulance response times. Interrupted time series analyses compared control and matched intervention sites pre-AIMS and post-AIMS. Cost-effectiveness analyses compared the component costs of AIMS to usual care before with results presented from the National Health Service and social care prospective. The number of diversions away from ED required for a service to be cost neutral was determined. Results Analyses found considerable variation across sites, only one service was associated with a significant reduction in ED attendances (−4.89, p Conclusions AIMSs have variable effects on the emergency care system, reflecting variable structures and processes, but may be associated with modest reductions in the burden on ED and ambulance services. The more expensive model, supported by the ED, was the only configuration likely to divert patients away from ED. AIMS should be regarded as fledgling services that require further work to realise benefit. Trial registration number ISRCTN63096364.

/pdf/controlled-observational-study-and-economic-evaluation-of-5fou1vn0sw.pdf

Controlled observational study and economic evaluation of the effect of city-centre night-time alcohol intoxication management services on the emergency care system compared with usual care

Steve Goodacre

Papers

View from the United Kingdom: chest pain center progress.

131utility of the 4at rapid assessment instrument in assessment of delirium and cognitive impairment in acute care

Research priorities for prehospital care of older patients with injuries: scoping review

Meta-analysis: The value of clinical assessment in the diagnosis of deep vein thrombosis

Controlled observational study and economic evaluation of the effect of city-centre night-time alcohol intoxication management services on the emergency care system compared with usual care