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https://www.readbyqxmd.com/read/28073653/rare-lateral-dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-review-of-the-literature
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
December 12, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27940505/a-previously-healthy-adolescent-with-acute-encephalopathy-and-decorticate-posturing
#8
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
#9
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...
October 11, 2016: 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
#10
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
#11
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
#12
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
#13
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...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27896323/intra-articular-lidocaine-versus-intravenous-sedative-and-analgesic-for-reduction-of-anterior-shoulder-dislocation
#14
Parvin Kashani, Fatemeh Asayesh Zarchi, Hamid Reza Hatamabadi, Abbas Afshar, Marzieh Amiri
OBJECTIVE: This prospective clinical trial was performed to compare the safety and efficiency of intra-articular lidocaine (IAL) versus intravenous sedative and analgesic (IVSA) in reduction of anterior shoulder dislocation. MATERIALS AND METHODS: Patients with anterior shoulder dislocation were randomly divided into 2 groups to receive IAL and IVSA. One group patients received an intravenous dose of 0.05 mg/kg midazolam and 1 μg/kg fentanyl, while the other group received 20 mL intra-articular lidocaine (1%)...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27882039/pediatric-tooth-extractions-under-sedoanalgesia
#15
Ayse Hande Arpaci, Berrin Isik
OBJECTIVE: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. METHODS: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS)...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27866507/simulation-and-web-based-learning-increases-utilization-of-bier-block-for-forearm-fracture-reduction-in-the-pediatric-emergency-department
#16
Brett Burstein, Emmanuelle Fauteux-Lamarre, Adam Cheng, Dominic Chalut, Adam Bretholz
OBJECTIVES: Bier block (BB) is a safe and effective alternative to procedural sedation for analgesia during forearm fracture reductions, yet remains infrequently used in the pediatric emergency department (PED). No standardized methods of BB training have previously been described. The objective of this study was to determine whether a multimodal instructional course increases comfort with BB and translates to increased use of this technique. METHODS: A novel interdisciplinary simulation and Web-based training course was developed to teach the use of BB for forearm fracture reduction at a tertiary PED...
November 21, 2016: CJEM
https://www.readbyqxmd.com/read/27857987/the-comparison-of-the-efficiency-of-traditional-lectures-to-video-supported-lectures-within-the-training-of-the-emergency-medicine-residents
#17
Aydın Sarıhan, Neşe Colak Oray, Birdal Güllüpınar, Sedat Yanturali, Ridvan Atilla, Berna Musal
OBJECTIVES: Recent developments in computer and video technology, multimedia resources enter quickest way possible into medical education and have started to gain popularity. The aim of this study is to evaluate the impact of video-supported lectures on leaning, with comparison to traditional lectures. METHODS: According to lecture techniques, two separate groups; one is the traditional lectures group (TLG) and the other is video-supported lectures group (VSLG), are formed...
September 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27850539/901-trends-in-the-utilization-of-moderate-sedation-in-children-in-emergency-departments-in-the-usa
#18
Veerajalandhar Allareddy, Sankeerth Rampa, Veerasathpurush Allareddy, Marcelo Auslender, Lia Lowrie
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27842924/dexmedetomidine-use-in-the-emergency-department-for-control-of-methamphetamine-induced-agitation-a-report-of-two-cases
#19
Rex Pui Kin Lam, Wai Lam Yip, Chi Keung Wan, Matthew Sik Hon Tsui
BACKGROUND: Chemical restraint is often required to control agitation induced by methamphetamine. Dexmedetomidine is an α-2 adrenergic receptor agonist with sedative, analgesic, and sympatholytic properties. Its use in the emergency department (ED) to control methamphetamine-induced agitation has not been reported. OBJECTIVE: To report two cases of methamphetamine-induced agitation successfully sedated with dexmedetomidine in the ED. CASE REPORT: The first case was a 42-year-old man with unstable emotion and violent behaviours after smoking methamphetamine...
November 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27826189/behavioral-emergency-in-the-elderly-a-descriptive-study-of-patients-referred-to-an-aggression-response-team-in-an-acute-hospital
#20
Daniel Simpkins, Carmelle Peisah, Irene Boyatzis
AIM: The management of severely agitated elderly patients is not easy, and limited guidelines are available to assist practitioners. At a Sydney hospital, an Aggression Response Team (ART) comprising clinical and security staff can be alerted when a staff member has safety concerns. Our aims were to describe the patient population referred for ART calls, reasons for and interventions during ART calls, and complications following them. METHODS: Patients 65 years and older referred for ART calls in the emergency department or wards during 2014 were identified using the Incident Information Management System database and medical records were reviewed...
2016: Clinical Interventions in Aging
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