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https://www.readbyqxmd.com/read/28228343/ultrasound-guided-femoral-nerve-blockage-in-a-patellar-dislocation-an-effective-technique-for-emergency-physicians
#1
Sami Eksert, Sinan Akay, Murtaza Kaya, Ali Kantemir, Kenan Keklikci
BACKGROUND: Patellar dislocation is an orthopedic emergency and its reduction can be painful. The aim of this case is to show that the ultrasound-guided femoral nerve blockage can be effectively used in the pain management of patellar reduction in the emergency department (ED). CASE REPORT: A 21-year-old man was admitted to our ED after suffering a fall down a flight of stairs. The initial physical examination and plain radiography showed a patellar dislocation in the right knee...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28190665/intranasal-fentanyl-and-inhaled-nitrous-oxide-for-fracture-reduction-the-fan-observational-study
#2
J Hoeffe, E Doyon Trottier, B Bailey, D Shellshear, M Lagacé, C Sutter, G Grimard, R Cook, F E Babl
INTRODUCTION: Procedural sedation and analgesia (PSA) are frequently used for fracture reduction in pediatric emergency departments (ED). Combining intranasal (IN) fentanyl with inhalation of nitrous oxide (N2O) allow for short recovery time and obviates painful and time-consuming IV access insertions. METHODS: We performed a bicentric, prospective, observational cohort study. Patients aged 4-18years were included if they received combined PSA with IN fentanyl and N2O for the reduction of mildly/moderately displaced fracture or of dislocation...
January 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28177167/ketamine-as-an-adjunct-to-opioids-for-acute-pain-in-the-emergency-department-a-randomized-controlled-trial
#3
Karen J Bowers, Kelly B McAllister, Meredith Ray, Corey Heitz
OBJECTIVES: This study had five objectives: 1) to measure and compare total opioid use and number of opioid doses in patients treated with opioids versus ketamine in conjunction with opioids. 2) To measure pain scores up to 2 hours after presentation in the ED patient with pain, comparing standard opioid pain control to ketamine in conjunction with opioids. 3) To compare patient satisfaction with pain control using opioids alone versus ketamine in conjunction with opioids. 4) To monitor and compare side effects in patients treated with opioids versus ketamine in conjunction with opioids...
February 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28160494/intravenous-midazolam-droperidol-combination-droperidol-or-olanzapine-monotherapy-for-methamphetamine-related-acute-agitation-subgroup-analysis-of-a-randomised-controlled-trial
#4
Celene Y L Yap, David Mc D Taylor, Jonathan C Knott, Simone E Taylor, Georgina A Phillips, Jonathan Karro, Esther W Chan, David C M Kong, David J Castle
AIM: To examine the efficacy and safety of (1) midazolam-droperidol vs droperidol and (2) midazolam-droperidol vs olanzapine for methamphetamine-related acute agitation. DESIGN AND SETTING: A multi-centre, randomised, double-blind, controlled, clinical trial was conducted in two Australian emergency departments, between October 2014 and September 2015. PARTICIPANTS: Three hundred and sixty-one patients, aged 18-65 years, requiring intravenous medication sedation for acute agitation were enrolled...
February 4, 2017: Addiction
https://www.readbyqxmd.com/read/28131360/optimizing-care-of-the-mechanically-ventilated-patient-in-the-emergency-department-through-the-utilization-of-validated-sedation-scoring-scales
#5
Chelsie L Sanders, Kristin H Eginger
No abstract text is available yet for this article.
January 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28124199/the-effectiveness-of-rapid-sequence-intubation-rsi-versus-non-rsi-in-emergency-department-an-analysis-of-multicenter-prospective-observational-study
#6
Masashi Okubo, Koichiro Gibo, Yusuke Hagiwara, Yukiko Nakayama, Kohei Hasegawa
BACKGROUND: Although rapid sequence intubation (RSI) is the method of choice in emergency department (ED) airway management, data to support the use of RSI remain scarce. We sought to compare the effectiveness of airway management between RSI and non-RSI (intubation with sedative agents only or without medications) in the ED. METHODS: Secondary analysis of the data from a multicenter prospective observational registry at 13 Japanese EDs. All non-cardiac-arrest patients who underwent intubation with RSI or non-RSI were included for the analysis...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#7
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28073653/rare-lateral-dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-review-of-the-literature
#8
Amir Reza Vosoughi, Pascal F Rippstein
Traumatic lateral dislocations of the first metatarsophalangeal (MTP) joint are very rare. A 44-year-old male was referred after a motorcycle to car accident because of an exposed head of the left first metatarsal through a laceration on the medial aspect of the first MTP joint. Radiographs showed a lateral dislocation of the first MTP joint, with concomitant fractures of the neck of the second metatarsal and the base of the third and fourth metatarsal bones. The dislocation was reduced in the emergency department with the patient under conscious sedation after thorough irrigation...
January 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28073611/propofol-versus-midazolam-for-procedural-sedation-in-the-emergency-department-a-study-on-efficacy-and-safety
#9
Heleen Lameijer, Ytje T Sikkema, Albert Pol, Maike G E Bosch, Femke Beije, Rieneke Feenstra, Bas W J Bens, Ewoud Ter Avest
BACKGROUND: Procedural sedation for painful procedures in the emergency department (ED) can be accomplished with various pharmacological agents. The choice of the sedative used is highly dependent on procedure- and patient characteristics and on personal- or local preferences. METHODS: We conducted a multicenter retrospective cohort study of procedural sedations performed in the EDs of 5 hospitals in the Netherlands over a 4year period to evaluate the efficacy- (success rate of the intended procedure) and safety (incidence of sedation (adverse) events) of propofol sedations compared to midazolam sedations...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28057371/3-meo-pcp-intoxication-in-two-young-men-first-in-vivo-detection-in-italy
#10
Elisabetta Bertol, Jennifer Pascali, Diego Palumbo, Valeria Catalani, Maria Grazia Di Milia, Alessia Fioravanti, Francesco Mari, Fabio Vaiano
3-MeO-PCP or 3-methoxyphencyclidine is a derivative of phencyclidine. It acts as a dissociative anesthetic and it has allegedly hallucinogenic and sedative effects. There are almost no documented intoxication cases and references about its pharmacology and toxicity in literature. This study presents two concomitant intoxication cases due to consumption of 3-MeO-PCP and alcohol. A 19 (A) and a 21 years old (B) men were brought to Santa Maria Nuova Hospital in a comatose state (Glasgow score 3). They showed respiratory acidosis, right anisocoria with mydriatic pupils and hypothermia...
December 26, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28057073/a-comparison-of-emergency-airway-management-between-neuromuscular-blockades-alone-and-rapid-sequence-intubation-an-analysis-of-multicenter-prospective-study
#11
MULTICENTER STUDY
Nobuhiro Sato, Yusuke Hagiwara, Hiroko Watase, Kohei Hasegawa
BACKGROUND: Although airway management with neuromuscular blockade (NMB) alone is discouraged in the emergency department (ED), our previous study demonstrated that many patients were intubated using NMBs alone without sedatives. To refute this practice, we sought to compare the intubation success and adverse event rates between NMBs only and rapid sequence intubation (RSI). METHODS: This is a secondary analysis of the data from a prospective observational study of ED patients in 13 hospitals who underwent emergency airway management from April 2010 to August 2012...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28050700/when-is-it-safe-to-reduce-fracture-dislocation-of-shoulder-under-sedation-proposed-treatment-algorithm
#12
Konrad Sebastian Wronka, Abhimanyu Ved, Khitish Mohanty
INTRODUCTION: Shoulder dislocations are common. It is known that incongruent shoulder should be promptly reduced. However, when associated with fracture of the proximal humerus, there is a clinical dilemma if reduction under sedation is a safe option. We wanted to establish when it is safe to attempt reduction of a shoulder fracture dislocation under sedation in emergency room. METHODS: This is a retrospective cohort study assessing consecutive patients presenting with a dislocation of a gleno-humeral joint with an associated fracture of the humerus between 2007 and 2015...
January 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28032265/using-continuous-quantitative-capnography-for-emergency-department-procedural-sedation-a-systematic-review-and-cost-effectiveness-analysis
#13
Nicholas Matthew Mohr, Andrew Stoltze, Azeemuddin Ahmed, Elizabeth Kiscaden, Dan Shane
End-tidal CO2 has been advocated to improve safety of emergency department (ED) procedural sedation by decreasing hypoxia and catastrophic outcomes. This study aimed to estimate the cost-effectiveness of routine use of continuous waveform quantitative end-tidal CO2 monitoring for ED procedural sedation in prevention of catastrophic events. Markov modeling was used to perform cost-effectiveness analysis to estimate societal costs per prevented catastrophic event (death or hypoxic brain injury) during routine ED procedural sedation...
December 28, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27979641/awake-laryngoscopy-in-the-emergency-department
#14
Joseph E Tonna, Peter M C DeBlieux
BACKGROUND: Many emergency physicians gain familiarity with the laryngeal anatomy only during the brief view achieved during rapid sequence induction and intubation. Awake laryngoscopy in the emergency department (ED) is an important and clinically underutilized procedure. DISCUSSION: Providing benefit to the emergency physician through a slow, controlled, and deliberate examination of the airway, awake laryngoscopy facilitates confidence in the high-risk airway and eases the evolution to intubation, should it be required...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27940505/a-previously-healthy-adolescent-with-acute-encephalopathy-and-decorticate-posturing
#15
Yu Kawai, Andrea G DeMonbrun, Rebecca S Chambers, Danielle A Nolan, Bram A Dolcourt, Nasuh M Malas, Michael W Quasney
A 14-year-old previously healthy female was transferred from a local emergency department after being found unresponsive at home. Parental questioning revealed she had fever and pharyngitis 2 weeks before presentation. Past mental health history was negative, including concern for past or present suicidal ideation/attempts, suspected substance use, or toxic ingestion. In the emergency department, she was orotracheally intubated due to a Glasgow Coma Scale of 3. She was hemodynamically stable and euglycemic...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27939800/changes-in-blood-pressure-and-heart-rate-during-sedation-with-ketamine-in-the-pediatric-ed
#16
Adam C Patterson, Shernaz A Wadia, Douglas J Lorenz, Michelle D Stevenson
BACKGROUND: Ketamine is commonly used in the emergency department for short, painful procedures. We describe changes in blood pressure (BP) and heart rate (HR) during procedural sedation with ketamine, as these changes have not been well described in children. METHODS: We performed a secondary analysis of a prospective, observational study involving children aged 8 to 18 years who received procedural sedation with ketamine in a pediatric emergency department. Serial vital signs and sedation scores were recorded from baseline until recovery from ketamine procedural sedation...
February 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27933328/predictors-of-emesis-in-children-undergoing-procedural-sedation-with-intramuscular-ketamine-in-a-paediatric-emergency-department
#17
Shruthi Suryaprakash, Lai Peng Tham
INTRODUCTION: Emesis is one of the most common adverse events associated with ketamine sedation. However, the predictors of emesis have not been clearly studied among Asian children. This study aimed to determine the incidence and predictors of emesis in local children undergoing intramuscular (IM) ketamine sedation in the emergency department (ED), and identify high-risk groups(s), so that antiemetics may be administered prophylactically. METHODS: In a prospective observational study, all children requiring procedural sedation under IM ketamine in the paediatric ED between 1 April 2013 and 31 January 2015 were included...
December 9, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27918376/reduced-length-of-stay-and-adverse-events-using-bier-block-for-forearm-fracture-reduction-in-the-pediatric-emergency-department
#18
Emmanuelle Fauteux-Lamarre, Brett Burstein, Adam Cheng, Adam Bretholz
OBJECTIVES: Forearm fractures are among the most common pediatric injuries. Procedural sedation is frequently used for analgesia during fracture reduction but requires a prolonged recovery period and can be associated with adverse events. Bier block is a safe alternative for fracture reduction analgesia. This study sought to compare Bier block and procedural sedation for forearm fracture reduction. METHODS: We performed a retrospective study of patients aged 6 to 18 years, presenting with forearm fractures requiring closed reduction from June 2012 to March 2014...
January 1, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27904260/sonographic-identification-of-peripheral-nerves-in-the-forearm
#19
Saundra A Jackson, Charlotte Derr, Anthony De Lucia, Marvin Harris, Zuheily Closser, Branko Miladinovic, Rahul Mhaskar, Theresa Jorgensen, Lori Green
BACKGROUND: With the growing utilization of ultrasonography in emergency medicine combined with the concern over adequate pain management in the emergency department (ED), ultrasound guidance for peripheral nerve blockade in ED is an area of increasing interest. The medical literature has multiple reports supporting the use of ultrasound guidance in peripheral nerve blocks. However, to perform a peripheral nerve block, one must first be able to reliably identify the specific nerve before the procedure...
October 2016: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/27901291/success-rate-of-pneumatic-reduction-of-intussusception-with-and-without-sedation
#20
Oren Feldman, Giora Weiser, Mona Hanna, Ori Devir, Uri Balla, David W Johnson, Eran Kozer, Itai Shavit
BACKGROUND: Pneumatic reduction of ileocolic intussusception is often performed without sedation. The aim of this study was to evaluate the success rate of pneumatic reduction of intussusception with and without sedation. METHODS: We conducted a retrospective cohort study in Israel in two tertiary care centers using a similar protocol for pneumatic reduction of intussusception. In one center, patients had pneumatic reduction of intussusception under propofol-based sedation, while in the other, patients had pneumatic reduction of intussusception without any sedation...
February 2017: Paediatric Anaesthesia
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