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https://www.readbyqxmd.com/read/28334427/capnography-versus-standard-monitoring-for-emergency-department-procedural-sedation-and-analgesia
#1
REVIEW
Brian F Wall, Kirk Magee, Samuel G Campbell, Peter J Zed
BACKGROUND: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED, there is currently no consensus on whether the addition of capnography to standard monitoring modalities reduces adverse events in the ED setting...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28331860/quetiapine-misuse-and-abuse-is-it-an-atypical-paradigm-of-drug-seeking-behavior
#2
REVIEW
Sean Kim, Gayoung Lee, Eric Kim, Hyejin Jung, Jongwha Chang
Recent case reports in medical literatures suggest that more and more second-generation atypical antipsychotics (AAs) have been prescribed for off-label use; quetiapine (Brand name: Seroquel(®)) showed increase in its trend for off-label use. Little is known about the reasons behind this trend, although historical sedative and hypnotic prescription patterns suggest that despite relatively superior safety profiles of quetiapine (especially for movement disorders), it may be used for treating substance abuse disorder...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28325160/-procedural-sedation-and-analgesia-with-nitrous-oxide-for-children-in-the-emergency-department
#3
W P Kluijfhout, R T C Welsing
Procedural sedation and analgesia with nitrous oxide in children who are anxious or in pain is a relatively new type of sedation in emergency departments in the Netherlands. The gas is inhaled through a face mask and does not require intravenous access. Furthermore, nitrous oxide does not influence the circulatory and respiratory systems and airway reflexes remain intact, which means that the child does not need to be fasted. Children who are treated with nitrous oxide experience significantly less pain and discomfort compared to the application of conventional analgesia...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28325154/the-behavioral-profile-of-methylenedioxypyrovalerone-mdpv-and-%C3%AE-pyrrolidinopentiophenone-pvp-a-systematic-review
#4
Cornel N Stanciu, Thomas M Penders, Samantha A Gnanasegaram, Elvin Pirapakaran, Juvraj S Padda, Jeeven S Padda
BACKGROUND: New psychoactive substances are emerging at an alarming rate. With novel structures and properties they produce unique behavioral characteristics during intoxication. Synthetic cathinones are some of the most common. More and more are presenting to emergency departments due to consequences of use. Aside from isolated reports, little is known about these compounds. OBJECTIVE: Here we review literature pertaining to two common synthetic cathinones, MDPV and alphaPVP, and correlate clinically with guidance on management of intoxications...
March 21, 2017: Current Drug Abuse Reviews
https://www.readbyqxmd.com/read/28283340/a-prospective-randomized-double-dummy-trial-comparing-intravenous-push-dose-of-low-dose-ketamine-to-short-infusion-of-low-dose-ketamine-for-treatment-of-moderate-to-severe-pain-in-the-emergency-department
#5
Sergey Motov, Mo Mai, Illya Pushkar, Antonios Likourezos, Jefferson Drapkin, Matthew Yasavolian, Jason Brady, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Compare adverse effects and analgesic efficacy of low-dose ketamine for acute pain in the ED administered either by single intravenous push (IVP) or short infusion (SI). METHODS: Patients 18-65, presenting to ED with acute abdominal, flank, or musculoskeletal pain with initial pain score≥5, were randomized to ketamine 0.3mg/kg by either IVP or SI with placebo double-dummy. Adverse effects were evaluated by Side Effects Rating Scale for Dissociative Anesthetics (SERSDA) and Richmond Agitation-Sedation Scale (RASS) at 5, 15, 30, 60, 90, and 120min post-administration; analgesic efficacy was evaluated by Numerical Rating Scale (NRS)...
March 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28283304/minor-injury-crashes-prevalence-of-driver-related-risk-factors-and-outcome
#6
Jeffrey R Brubacher, Herbert Chan, Elizabeth Purssell, Benjamin J Tuyp, Daniel K Ting, Vahid Mehrnoush
BACKGROUND: The majority of crashes cause "minor" injuries (i.e., treated and released from the emergency department [ED]). Minor injury crashes are poorly studied. OBJECTIVES: This study aims to determine the prevalence of driver-related risk factors and subsequent outcome in drivers involved in minor crashes. METHODS: We interviewed a convenience sample of injured drivers, aged over 17 years, who were treated and released from the ED. Follow-up interviews were conducted 6 months after the crash...
March 7, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279542/the-use-of-ketamine-for-acute-treatment-of-pain-a-randomized-double-blind-placebo-controlled-trial
#7
Billy Sin, Tamara Tatunchak, Mohammad Paryavi, Maria Olivo, Usman Mian, Josel Ruiz, Bupendra Shah, Sylvie de Souza
BACKGROUND: Pain is one of the most common reasons for emergency department (ED) visits in the United States. Ketamine is a sedative with N-methyl-D-aspartate (NMDA) receptor antagonism. Recent literature has suggested that the use of subdissociative dose ketamine (SDDK) may be safe and effective for acute pain. OBJECTIVE: The objective of our study was to evaluate ketamine in subdissociative doses as an adjunct for acute pain in the ED. METHODS: This was a single-center, prospective, randomized, double-blind, placebo-controlled trial that evaluated the use of SDDK in adult patients who presented to the ED with acute pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28264690/presentations-to-an-urban-emergency-department-in-bern-switzerland-associated-with-acute-recreational-drug-toxicity
#8
Evangelia Liakoni, Sabine Müller, Adrian Stoller, Meret Ricklin, Matthias E Liechti, Aristomenis K Exadaktylos
BACKGROUND: Although the recreational use of psychoactive substances is common there is only limited systematic collection of data on acute drug toxicity or hospital presentations. Currently, data from Switzerland are only available from the University Hospital of Basel. The present study aimed to describe the presentations due to recreational drug use at an emergency department in Bern, Switzerland during a 4 year period. METHODS: Retrospective analysis of cases presenting from May 2012 to April 2016 at the emergency department of the University Hospital of Bern, Switzerland, with symptoms/signs consistent with acute toxicity of recreational drug use...
March 7, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28237385/ketamine-as-a-first-line-treatment-for-severely-agitated-emergency-department-patients
#9
Jeff Riddell, Alexander Tran, Rimon Bengiamin, Gregory W Hendey, Patil Armenian
OBJECTIVE: Emergency physicians often need to control agitated patients who present a danger to themselves and hospital personnel. Commonly used medications have limitations. Our primary objective was to compare the time to a defined reduction in agitation scores for ketamine versus benzodiazepines and haloperidol, alone or in combination. Our secondary objectives were to compare rates of medication redosing, vital sign changes, and adverse events in the different treatment groups. METHODS: We conducted a single-center, prospective, observational study examining agitation levels in acutely agitated emergency department patients between the ages of 18 and 65 who required sedation medication for acute agitation...
February 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228343/ultrasound-guided-femoral-nerve-blockage-in-a-patellar-dislocation-an-effective-technique-for-emergency-physicians
#10
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
#11
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
#12
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; and 5) to identify effect variation between different subgroups of patients, with the purpose of focusing future research...
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-randomized-controlled-trial
#13
Celene Y L Yap, David McD 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 versus droperidol and (2) midazolam-droperidol versus olanzapine for methamphetamine-related acute agitation. DESIGN AND SETTING: A multi-centre, randomized, 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 into this study...
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
#14
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
#15
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
#16
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
#17
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...
March 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
#18
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
#19
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
#20
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
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