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https://www.readbyqxmd.com/read/28802082/ketamine-or-ketofol-do-we-have-enough-evidence-to-know-which-one-to-use
#1
James Miner
Ketamine and propofol are both commonly used emergency department (ED) procedural sedation agents. Their concurrent administration, often referred to as "ketofol", is widely used for procedural sedation. A simple google search can lead to a lot of opinions on why we should use propofol, ketamine, or ketofol in a given situation for moderate or deep procedural sedation in the ED, but finding evidence that supports differences these opinions assume is much harder to come by. This article is protected by copyright...
August 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28800811/violence-in-the-emergency-department-a-global-problem
#2
REVIEW
Allison Tadros, Christopher Kiefer
Violence against health care workers is an unfortunately common event. Because of several inherent factors, emergency departments are particularly vulnerable. Once an incident occurs, it often goes unreported and leads to both physical and mental trauma. Health care workers should learn to recognize the cues that patients are escalating toward violence and be familiar with various options for sedating agitated patients. If sedation is not successful, physical restraint may become necessary. There are measures that can be taken that may help minimize the likelihood of violence toward health care workers...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28782658/patterns-of-treatment-of-accidental-genital-trauma-in-girls
#3
Tazim Dowlut-McElroy, Jeanette Higgins, Karen B Williams, Julie L Strickland
STUDY OBJECTIVE: To evaluate the characteristics of girls with accidental genital trauma (AGT) who can be managed in the emergency department (ED) versus the operating suite (OS). DESIGN: Retrospective cohort. SETTING: ED at a children's hospital in a metropolitan area. PARTICIPANTS: Girls aged 0 to 18 years with AGT. MAIN OUTCOME MEASURES: Factors associated with need for evaluation and repair of AGT in the OS...
August 3, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28768699/use-of-a-23-hour-emergency-department-observation-unit-for-the-management-of-patients-with-toxic-exposures
#4
Rupeng Mong, Gabriel Joseph Arciaga, Hock Heng Tan
BACKGROUND: A significant proportion of patients with toxic exposures presenting to the ED require admission. However, most will improve within 24 hours, and so could potentially be managed in a short-stay observation unit. We describe the management and outcomes of these patients in a 23-hour ED observation unit (EDOU). METHODS: A retrospective chart review of all patients with toxic exposures admitted to the EDOU in Singapore between 1 April 2013 and 31 March 2015 was performed...
August 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28758605/rescue-extracorporeal-membrane-oxygenation-therapy-in-methamphetamine-toxicity
#5
Laura K Morrison, J Kromm, J Gaudet, D Zuege, B Button, F Warshawski, S N Lucyk
Complications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use...
July 31, 2017: CJEM
https://www.readbyqxmd.com/read/28754357/what-is-the-utility-of-end-tidal-capnography-for-procedural-sedation-and-analgesia-in-the-emergency-department
#6
EDITORIAL
Michael Gottlieb, Melissa Rice
No abstract text is available yet for this article.
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28750729/-preparation-of-sedation-analgesia-procedures-in-spanish-paediatric-emergency-departments-a-descriptive-study
#7
Concepción Míguez, Niki Oikonomopoulou, Jorge Lorente, Paula Vázquez
INTRODUCTION: The objective of this study was to describe the current practice regarding the preparation of the sedation-analgesia (SA) procedures performed in the paediatric emergency centres in Spain. MATERIAL AND METHODS: A multicentre, observational and prospective analytical study was carried out on the SA procedures that were performed on children under 18 years-old in 18 paediatric emergency departments between February 2015 and January 2016. RESULTS: A total of 658 SA procedures were registered in 18 hospitals of Spain, most of them to children older than 24 months...
July 24, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28729305/biomechanical-reposition-techniques-in-anterior-shoulder-dislocation-a-randomised-multicentre-clinical-trial-the-brasd-trial-protocol
#8
David N Baden, Martijn H Roetman, Tom Boeije, Floris Roodheuvel, Nieke Mullaart-Jansen, Suzanne Peeters, Mike D Burg
INTRODUCTION: Glenohumeral (shoulder) dislocations are the most common large joint dislocations seen in the emergency department (ED). They cause pain, often severe, and require timely interventions to minimise discomfort and tissue damage. Commonly used reposition or relocation techniques often involve traction and/or leverage. These techniques have high success rates but may be painful and time consuming. They may also cause complications. Recently, other techniques-the biomechanical reposition techniques (BRTs)-have become more popular since they may cause less pain, require less time and cause fewer complications...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28701350/effectiveness-of-interventions-to-improve-medication-use-during-rapid-sequence-intubation-in-a-pediatric-emergency-department
#9
Michelle C Caruso, Jenna R Dyas, Matthew R Mittiga, Andrea S Rinderknecht, Benjamin T Kerrey
PURPOSE: Results of a study to determine whether checklist-based interventions improved the selection and administration of rapid-sequence intubation (RSI) medications in a pediatric emergency department (ED) are reported. METHODS: A retrospective study of data collected during a quality-improvement project was conducted. Data sources included the electronic health record and video review. The central intervention was use of a 21-item RSI checklist, which included guidance for the physician team leader on medication selection and timing...
July 12, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28697164/the-use-safety-and-efficacy-of-olanzapine-in-a-level-i-pediatric-trauma-center-emergency-department-over-a-10-year-period
#10
Jon B Cole, Lauren R Klein, Ashley M Strobel, Stephane R Blanchard, Rebecca Nahum, Marc L Martel
OBJECTIVES: Olanzapine is a second-generation antipsychotic increasingly used in emergency medicine for many indications. Literature on its use in children is sparse. Our objectives were to describe the use, safety, and efficacy of olanzapine in pediatric emergency patients. METHODS: A structured chart review was performed of patients 18 years old or younger receiving olanzapine from 2007 to 2016 in the emergency department of a pediatric level I trauma center. RESULTS: A total of 285 children received olanzapine...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28688769/revisit-subsequent-hospitalization-recurrent-fall-and-death-within-6-months-after-a-fall-among-elderly-emergency-department-patients
#11
Jiraporn Sri-On, Gregory P Tirrell, Jonathan F Bean, Lewis A Lipsitz, Shan W Liu
STUDY OBJECTIVE: We seek to describe the risk during 6 months and specific risk factors for recurrent falls, emergency department (ED) revisits, subsequent hospitalizations, and death within 6 months after a fall-related ED presentation. METHODS: This was a secondary analysis of a retrospective cohort of elderly fall patients who presented to the ED from one urban teaching hospital. We included patients aged 65 years and older who had an ED fall visit in 2012. We examined the frequency and risk factors of adverse events (composite of recurrent falls, ED revisits, subsequent hospitalization, and death, selected a priori) at 6 months...
June 29, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28680511/emergency-department-procedural-sedation-for-primary-electrical-cardioversion-a-comparison-with-procedural-sedations-for-other-reasons
#12
Michael Butler, Patrick Froese, Peter Zed, George Kovacs, Robert MacKinley, Kirk Magee, Mary-Lynn Watson, Samuel G Campbell
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia treated in the emergency department (ED), with primary electrical cardioversion (PEC) the preferred method of rhythm control. Anecdotally, patients undergoing ED procedural sedation (EDPS) for PEC differ from those requiring EDPS for other procedures: they are at higher risk of adverse events, and require fewer drugs and lower doses. We attempt to verify this using an EDPS registry at a Canadian, tertiary care teaching hospital...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28675451/rates-of-delirium-diagnosis-do-not-improve-with-emergency-risk-screening-results-of-the-emergency-department-delirium-initiative-trial
#13
Glenn Arendts, Jennefer Love, Yusuf Nagree, David Bruce, Malcolm Hare, Ian Dey
OBJECTIVES: To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. DESIGN: Prospective trial with sequential introduction of screening and interventional processes. SETTING: Two tertiary referral hospitals in Australia. PARTICIPANTS: Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905)...
July 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28670686/anaesthesia-practices-for-endovascular-therapy-of-acute-ischaemic-stroke-a-nordic-survey
#14
M Rasmussen, C Z Simonsen, L H Sørensen, S Dyrskog, D A Rusy, D Sharma, N Juul
BACKGROUND: The optimal method of anaesthesia for endovascular therapy (EVT) in acute ischaemic stroke (AIS) has not been identified. Nordic departments of anaesthesiology may handle EVT cases for AIS differently. The aim of this survey was to describe the current practice patterns of Nordic anaesthesia departments in anaesthetic management of EVT in AIS. METHODS: A survey consisting of 13 questions was sent to one qualified individual at all Nordic departments of anaesthesiology who manage anaesthesia for EVT interventions...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28659207/-ecstasy-light-not-as-light-as-its-name-suggests-toxic-effects-of-4-fluoroamphetamine
#15
M C J Knippels, I M M Essers, F J H Magdelijns, D J L van Twist
BACKGROUND: The use of 4-fluoroamphetamine (4-FA) has shown a marked increase, especially because users perceive its effects to be relatively mild. 4-FA is also known as ecstacy-light, but is probably not as light as its name suggests. From April 2017 its use has therefore been forbidden in the Netherlands. CASE DESCRIPTION: In a short time, we saw three patients at our emergency department who had signs of a severe intoxication with 4-FA. A 21-year-old male developed a tonic-clonic seizure, bruxism, mydriasis, and rhabdomyolysis...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#16
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28645462/analgosedation-practices-and-the-impact-of%C3%A2-sedation-depth-on-clinical-outcomes-among-patients-requiring-mechanical-ventilation-in-the-ed-a-cohort-study
#17
Robert J Stephens, Enyo Ablordeppey, Anne M Drewry, Christopher Palmer, Brian T Wessman, Nicholas M Mohr, Brian W Roberts, Stephen Y Liang, Marin H Kollef, Brian M Fuller
BACKGROUND: Analgesia and sedation are cornerstone therapies for mechanically ventilated patients. Despite data showing that early deep sedation in the ICU influences outcome, this has not been investigated in the ED. Therefore, ED-based sedation practices, and their influence on outcome, remain incompletely defined. This study's objectives were to describe ED sedation practices in mechanically ventilated patients and to test the hypothesis that ED sedation depth is associated with worse outcomes...
June 21, 2017: Chest
https://www.readbyqxmd.com/read/28625000/mechanical-restraint-in-an-emergency-department-a-consecutive-series-of-593-cases
#18
Nicolas Beysard, Bertrand Yersin, Pierre-Nicolas Carron
The objective is to describe the characteristics of mechanically restrained patients in the emergency department (ED) of a university hospital and to evaluate the quality of restraint documentation that was filled out according to the dedicated protocol with respect to the law on restraint. All adult patients (≥16 years) who were admitted to the ED from January 2009 to December 2010 and were mechanically restrained were included. We assessed medical and demographic characteristics, the completeness of the dedicated protocol, and the concomitant use of chemical sedation...
June 17, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28621182/-non-intubated-uniportal-video-assisted-thoracic-surgery-vats-lobectomy-as-a-new-procedure-in-our-department
#19
József Furák, Zsolt Szabó, Theodor Horváth, Tibor Géczi, Balázs Pécsy, Tibor Németh, Aurél Ottlakán, Zsolt Molnár, György Lázár
AIM: Due to the emerging experience in VATS (video assisted thoracic surgery) lobectomies, in some centers the so called "non-intubated" VATS lobectomies (NITS - non-intubated thoracic surgery) gained increased authority, during which endotracheal intubation and muscle relaxation of the patient is not carried out, thus surgery is being performed with the patient breathing spontaneously. The recent study deals with our initial experience gained during uniportal NITS VATS lobectomies. PATIENTS AND METHOD: Between 24...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28616616/lipoprotein-associated-phospholipase-a2-activity-and-its-diagnostic-potential-in-patients-with-acute-coronary-syndrome-and-acute-ischemic-stroke
#20
Sedat Kocak, Birsen Ertekin, Abdullah Sadik Girisgin, Zerrin Defne Dundar, Mehmet Ergin, Idris Mehmetoglu, Said Bodur, Basar Cander
BACKGROUND: The study examined the Lp-PLA2 activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value. METHODS: The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups...
June 2017: Turkish Journal of Emergency Medicine
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