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Procedural sedation EM

Gaël Jp Smits, Maybritt I Kuypers, Lisette Aa Mignot, Eef Pj Reijners, Erick Oskam, Karen Van Doorn, Wendy Amh Thijssen, Erik Hm Korsten
OBJECTIVE: To describe our experience performing ED procedural sedation in a country where emergency medicine (EM) is a relatively new specialty. METHODS: This is a prospective observational study of adult patients undergoing procedural sedation by emergency physicians (EPs) or EM residents in eight hospitals in the Netherlands. Data were collected on a standardised form, including patient characteristics, sedative and analgesic used, procedural success, adverse events (classified according to World SIVA) and rescue interventions...
April 2017: Emergency Medicine Journal: EMJ
Siobhán McCoy, Mark D Lyttle, Stuart Hartshorn, Philip Larkin, Maria Brenner, Ronan O'Sullivan
INTRODUCTION: There is extensive literature on paediatric procedural sedation (PPS) and its clinical applications in emergency departments (EDs). While numerous guidance and policy documents exist from international bodies, there remains a lack of uniformity and consistency of PPS practices within EDs. PPS is now gaining traction in the UK and Ireland and this study aimed to describe existing PPS practices and identify any challenges to training and provision of ED-based PPS. METHODS: A qualitative approach was employed to capture data through a focus group interview...
August 2016: Emergency Medicine Journal: EMJ
Magdalena E Cudny, N Ewen Wang, Sandra L Bardas, Carolyn N Nguyen
PURPOSE: To determine the agents used by emergency medicine (EM) physicians in pediatric procedural sedation and the associated adverse events (AEs) and to provide recommendations for optimizing drug therapy in pediatric patients. METHODS: We conducted a prospective study at Stanford Hospital's pediatric emergency department (ED) from April 2007 to April 2008 to determine the medications most frequently used in pediatric procedural sedation as well as their effectiveness and AEs...
February 2013: Hospital Pharmacy
Rovina Fiona Pinto, Munsif Bhimani, William Ken Milne, Kathryn Nicholson
INTRODUCTION: Several agents can be administered during procedural sedation and analgesia (PSA) in the emergency department (ED). The purpose of this study was to determine the PSA agents commonly used by physicians working in nontertiary EDs, and to assess the physicians' comfort level administering the agents as well as their knowledge of adverse effects of the agents. METHODS: We distributed a confidential electronic survey to physicians working in nontertiary EDs in southwestern Ontario...
2013: Canadian Journal of Rural Medicine
Kevin J Biese, Cory R Forbach, Richard P Medlin, Timothy F Platts-Mills, Matthew J Scholer, Brenda McCall, Frances S Shofer, Michael LaMantia, Cherri Hobgood, J S Kizer, Jan Busby-Whitehead, Charles B Cairns
OBJECTIVES: An estimated 14% to 25% of all scientific studies in peer-reviewed emergency medicine (EM) journals are medical records reviews. The majority of the chart reviews in these studies are performed manually, a process that is both time-consuming and error-prone. Computer-based text search engines have the potential to enhance chart reviews of electronic emergency department (ED) medical records. The authors compared the efficiency and accuracy of a computer-facilitated medical record review of ED clinical records of geriatric patients with a traditional manual review of the same data and describe the process by which this computer-facilitated review was completed...
June 2013: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Emma Lawrey, Peter Jones, Robin Mitchell
OBJECTIVE: Prosthetic hip dislocation is common. This study compares prosthetic hip relocations attempted within the ED by emergency doctors and those under orthopaedic care in the ED or operating theatre (OT). METHODS: Retrospective cohort study of patients presenting to Auckland City Hospital Adult Emergency Department with prosthetic hip dislocations between 1 January 2003 and 14 April 2008. Primary outcomes were proportion of successful relocation attempts and length of hospital stay...
April 2012: Emergency Medicine Australasia: EMA
Michael C Wadman, Benjamin Fago, Lance H Hoffman, T Paul Tran, Robert L Muelleman
INTRODUCTION: Strategies for increasing the numbers of American Board of Emergency Medicine certified/emergency medicine (EM) residency trained physicians practicing in rural emergency departments (EDs) include providing rural EM experiences during residency training. However, no studies to date describe the clinical work of EM residents rotating in a rural ED. The objective of the study was to compare the clinical experience of EM residents participating in a rural ED rotation with that on an urban university-based ED rotation...
April 2010: Rural and Remote Health
Jeffrey Druck, Morgan A Valley, Steven R Lowenstein
OBJECTIVES: The Residency Review Committee training requirements for emergency medicine residents (EM) are defined by consensus panels, with specific topics abstracted from lists of patient complaints and diagnostic codes. The relevance of specific curricular topics to actual practice has not been studied. We compared residency graduates' self-assessed preparation during training to importance in practice for a variety of EM procedural skills. METHODS: We distributed a web-based survey to all graduates of the Denver Health Residency Program in EM over the past 10 years...
August 2009: Western Journal of Emergency Medicine
Emily N Maher, Samantha F Hansen, Margaret Heine, Holley Meers, Myron Yaster, Elizabeth A Hunt
OBJECTIVES: Pediatric procedural sedation and analgesia (PSA) is unique. The goals of this study were to examine emergency medicine (EM) physicians' baseline knowledge of general and pediatric PSA compared with that of other nonanesthesiologist physicians and to test effectiveness of a seminar required for credentialing in PSA. METHODS: This was a retrospective, before and after interventional study of participants in a major university teaching hospital's PSA course...
December 2007: Pediatric Emergency Care
Dominic P Lu, Gabriel P Lu, Winston I Lu
The data presented in this article was collected after reviewing clinical findings gathered from using various anxiety control methods on apprehensive patients. We examined clinical applications of the eye movement (EM) component of Eye Movement Desensitization (EMD) on fearful dental patients who have histories of traumatic dental experiences. We also used Bi-Digital O-Ring Test (BDORT) to select the proper dosage of sedative to minimize the adverse side effects. For patients who did not respond well to EM, we used BDORT to select the proper sedative medication and its dosage...
2007: Acupuncture & Electro-therapeutics Research
Steven B Bird, David R Lane
BACKGROUND: Personal Digital Assistants (PDAs) have been integrated into daily practice for many emergency physicians and house officers. Few objective data exist that quantify the effect of PDAs on documentation. The objective of this study was to determine whether use of a PDA would improve emergency medicine house officer documentation of procedures and patient resuscitations. METHODS: Twelve first-year Emergency Medicine (EM) residents were provided a Palm V (Palm, Inc...
2006: BMC Medical Informatics and Decision Making
R L Chioléro, P Schoettker
The reasons for sedation in neurointensive care can be divided into two main groups: (i) general indications, as for other intensive care patients, such as to allow the necessary treatments (therapeutic facilitation), controlling the states of agitations em leader; (ii) specific indications due to the neuro-physiologic effect of the sedatives: facilitation of the control of the intracranial pressure and lowering of the cortical excitability during the epileptic fits and thereby helping the recovery of the cerebral tissue and diminishing the secondary brain insults...
May 2004: Annales Françaises D'anesthèsie et de Rèanimation
J Vesper, F Klostermann, T Funk, M Bock
Deep Brain Stimulation (DBS, chronic high frequency stimulation) is well established for Parkinson's disease and tremordominant movement disorders. Generalized dystonia is known as a type of movement disorder in which therapeutic options are very limited. A case of generalized dystonia is reported which was successfully treated by DBS in the Globus pallidus internus (GPI). A 26 years old male suffered from severe torsion dystonia of the lower limbs. The onset of symptoms was at age 7. It started with dystonia of the left foot...
2002: Zentralblatt Für Neurochirurgie
Chen-Hwan Cherng, Chih-Shung Wong, Fang-Lin Chang, Shung-Tai Ho, Chian-Her Lee
UNLABELLED: We conducted a randomized, double-blinded study to examine the onset time of tourniquet pain during epidural lidocaine anesthesia either with or without morphine in the epidural solution. Forty-five patients undergoing knee surgery with a thigh tourniquet were randomly allocated into 3 groups of 15 patients each: epidural morphine (EM; epidural administration of 17 mL of 2% lidocaine plus 2 mg of morphine, followed by IV injection of 0.2 mL of normal saline), IV morphine (IVM; 17 mL of 2% lidocaine plus 0...
June 2002: Anesthesia and Analgesia
R Carmona-Sánchez, J Valerio-Ureña, M A Valdovinos-Díaz
BACKGROUND: Esophageal manometry (EM) is a functional study performed without sedation. The insertion of a catheter through nasal passages provokes the greatest discomfort as it is being performed. OBJECTIVE: To evaluate the usefulness of lidocaine jelly to diminish discomfort patient during EM and to ease the procedure. MATERIAL AND METHODS: Ninety patients sent to EM were randomly assigned to receive lidocaine jelly at 2% (n = 45) or chlorexidine gluconate (n = 45) as a lubricant for the catheter...
July 2001: Revista de Gastroenterología de México
S B Bird, R S Zarum, F P Renzi
OBJECTIVE: To determine whether emergency medicine (EM) resident documentation of procedures, patient encounters, and patient follow-ups improved after implementation of a personal digital assistant (PDA) hand-held recording system. METHODS: All first-year EM residents were provided a PalmV (Palm, Inc., Santa Clara, CA) PDA. A customized patient procedure and encounter program was constructed using Pendragon Forms (Pendragon Software Corporation, Libertyville, IL) and loaded into each PDA...
December 2001: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
G Innes, M Murphy, C Nijssen-Jordan, J Ducharme, A Drummond
Procedural sedation and analgesia are core skills in emergency medicine. Various specialty societies have developed guidelines for procedural sedation, each reflecting the perspective of the specialty group. Emergency practitioners are most likely to embrace guidelines developed by people who understand emergency department (ED) skills, procedures, conditions, and case mix. Recognizing this, the Canadian Association of Emergency Physicians (CAEP) determined the need to establish guidelines for procedural sedation in the ED...
January 1999: Journal of Emergency Medicine
D K Nakayama, N A Shorter, J T Boyle, J B Watkins, J A O'Neill
The therapeutic approach to children with achalasia of the esophagus is controversial. Both pneumatic dilatation (PD) and Heller esophageal myotomy (EM) are considered effective, while bougienage has been discarded by most authorities. To determine the best place for each in the therapy of achalasia, 19 cases treated since 1964 were reviewed. Ages ranged from 9 months to 17 years (median 11 years), and duration of symptoms ranged from 4 months to 8 years (median 1 year). Three patients had symptoms from infancy...
July 1987: Journal of Pediatric Surgery
A J Koster, H Chen, J W Sedat, D A Agard
Instrumentation and methodology for the automatic collection of tomographic tilt series data for the three-dimensional reconstruction of single particles is described. The system consists of a Philips EM 430 TEM, with a Gatan 673 cooled slow-scan CCD camera and a Philips C400 microscope computer control unit attached. The procedure for data collection includes direct digital recording of the images on the CCD camera and the automatic measurement and correction of (a) image shifts resulting from tilting the specimen, (b) variation of defocus and (c) the eucentric height position of the specimen...
October 1992: Ultramicroscopy
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