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ER Techniques

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166 papers 100 to 500 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/27912926/acute-management-of-refractory-and-unstable-pediatric-supraventricular-tachycardia
#1
Jonathan Lewis, Gaurav Arora, Dana L Tudorascu, Robert W Hickey, Richard A Saladino, Mioara D Manole
OBJECTIVE: To characterize the management of acute pediatric supraventricular tachycardia (SVT), placing special emphasis on infants, patients refractory to adenosine (refractory SVT), and patients with hypotension, poor perfusion, or altered mental status (unstable SVT). STUDY DESIGN: Retrospective cohort study of patients 0-18 years of age without congenital heart disease who presented to our pediatric hospital from January 2003 to December 2012 for the treatment of acute SVT...
November 22, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27908918/alpha-blockers-for-treatment-of-ureteric-stones-systematic-review-and-meta-analysis
#2
John M Hollingsworth, Benjamin K Canales, Mary A M Rogers, Shyam Sukumar, Phyllis Yan, Gretchen M Kuntz, Philipp Dahm
OBJECTIVE:  To investigate the efficacy and safety of alpha blockers in the treatment of patients with ureteric stones. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  Cochrane Central Register of Controlled Trials, Web of Science, Embase, LILACS, and Medline databases and scientific meeting abstracts to July 2016. REVIEW METHODS:  Randomized controlled trials of alpha blockers compared with placebo or control for treatment of ureteric stones were eligible...
December 1, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27872051/management-of-mild-hypertension-in-adults
#3
REVIEW
Anthony J Viera, Emily M Hawes
Elevated blood pressure is a common risk factor for cardiovascular disease and affects one in three adults. Blood pressure lowering drugs substantially reduce the risk of stroke, coronary heart disease, heart failure, and premature death, but most clinical trials showing benefits have primarily included patients with moderate to severe hypertension, known cardiovascular disease, or elevated risk of cardiovascular disease. The benefits of treating mild hypertension in patients without cardiovascular disease are less clear, but recent meta-analyses offer some insights...
November 21, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27858189/ambulatory-or-inpatient-management-of-mild-tbi-in-children-a-post-concussion-analysis
#4
Danielle S Wendling-Keim, Adriana König, Hans-Georg Dietz, Markus Lehner
BACKGROUND: Diagnosis and treatment of children with mild traumatic brain injury (mTBI) remain a challenge since initial signs and symptoms do not always indicate the severity of the trauma. Therefore, guidelines regarding the decision upon imaging methods and ambulatory or hospitalized treatment are needed. The goal of our study was to investigate if the standard that was allied from the PECARN rules and is applied in this study can ensure that patients with clinically important brain injury are recognized and leads to outcomes with a low complication rate, a high patient satisfaction and minimal post-concussion syndrome incidence...
November 17, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27856005/mobile-universal-lexicon-evaluation-system-mules-test-a-new-measure-of-rapid-picture-naming-for-concussion
#5
Lucy Cobbs, Lisena Hasanaj, Prin Amorapanth, John-Ross Rizzo, Rachel Nolan, Liliana Serrano, Jenelle Raynowska, Janet C Rucker, Barry D Jordan, Steven L Galetta, Laura J Balcer
OBJECTIVE: This study introduces a rapid picture naming test, the Mobile Universal Lexicon Evaluation System (MULES), as a novel, vision-based performance measure for concussion screening. The MULES is a visual-verbal task that includes 54 original photographs of fruits, objects and animals. We piloted MULES in a cohort of volunteers to determine feasibility, ranges of picture naming responses, and the relation of MULES time scores to those of King-Devick (K-D), a rapid number naming test...
November 4, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27863850/pediatric-concussion-management-in-the-emergency-department-a-national-survey-of-parents
#6
Angela Zamarripa, Sarah J Clark, Alexander J Rogers, Helena Wang-Flores, Rachel M Stanley
OBJECTIVE: To examine parental expectations and beliefs about diagnosis and management of pediatric concussion. STUDY DESIGN: We conducted a cross-sectional web-based survey of a nationally representative panel of US parents in March 2014. Parents of 10- to 17-year-old children responded to questions about their expectations and beliefs about diagnosis and management of pediatric concussion in the emergency department (ED). Weighted percentages for descriptive statistics were calculated, and χ2 statistics were used for bivariate analysis...
November 16, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27864392/bet-1-trimethoprim-sulfamethoxazole-in-uncomplicated-skin-abscess
#7
Reece Baker, Jason Seamon
A short cut review was carried out to establish whether incision and drainage followed by treatment with oral trimethoprim-sulfamethoxazole is better than incision and drainage alone at treating patients with uncomplicated skin abscesses. One hundred and ninety-seven papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated...
December 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27864394/bet-2-low-dose-ketamine-for-acute-pain-in-the-ed
#8
Colby Duncan, Brad Riley
A short cut review was carried out to establish whether low-dose ketamine is better than morphine at safely and effectively reducing pain scores in ED patients with acute pain who do not respond to conventional therapies. One hundred and thirty-two papers were found using the reported searches, of these three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated...
December 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27821461/emergency-contraception
#9
Diana Hsiang, Sheila Dunn
No abstract text is available yet for this article.
December 6, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27802505/diagnosis-of-gout-a-systematic-review-in-support-of-an-american-college-of-physicians-clinical-practice-guideline
#10
Sydne J Newberry, John D FitzGerald, Aneesa Motala, Marika Booth, Margaret A Maglione, Dan Han, Abdul Tariq, Claire E O'Hanlon, Roberta Shanman, Whitney Dudley, Paul G Shekelle
Background: Alternative strategies exist for diagnosing gout that do not rely solely on the documentation of monosodium urate (MSU) crystals. Purpose: To summarize evidence regarding the accuracy of clinical tests and classification algorithms compared with that of a reference standard of MSU crystals in joint aspirate for diagnosing gout. Data Sources: Several electronic databases from inception to 29 February 2016. Study Selection: 21 prospective cohort, cross-sectional, and case-control studies including participants with joint inflammation and no previous definitive gout diagnosis who had MSU analysis of joint aspirate...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27802506/the-long-and-winding-road-to-clinical-guidelines-on-the-diagnosis-and-management-of-gout
#11
Robert M McLean
No abstract text is available yet for this article.
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27802507/to-treat-or-not-to-treat-to-target-in-gout
#12
Tuhina Neogi, Ted R Mikuls
No abstract text is available yet for this article.
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27802508/management-of-acute-and-recurrent-gout-a-clinical-practice-guideline-from-the-american-college-of-physicians
#13
Amir Qaseem, Russell P Harris, Mary Ann Forciea
Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of gout. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials; systematic reviews; and large observational studies published between January 2010 and March 2016. Clinical outcomes evaluated included pain, joint swelling and tenderness, activities of daily living, patient global assessment, recurrence, intermediate outcomes of serum urate levels, and harms...
November 1, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27707527/chemical-agents-for-the-sedation-of-agitated-patients-in-the-ed-a-systematic-review
#14
Viola Korczak, Adrienne Kirby, Naren Gunja
OBJECTIVE: Chemical agents commonly used to sedate agitated patients in the emergency department include benzodiazepines, antipsychotics, or a combination of the 2 classes. Our objective was to determine if a class or combination therapy is (1) more effective, as measured by the proportion sedated at 15-20 minutes and the need for repeat sedation, and (2) safer, as measured by the proportion of reported adverse events. METHODS: Systematic literature review and meta-analysis of studies comparing 2 or more chemical agents for sedation of agitated patients in the emergency department were carried out in PubMed, PsycINFO, Embase, and the Cochrane database...
September 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27717722/computed-tomography-interpretations-in-multiply-injured-patients-comparison-of-emergency-physicians-and-on-call-radiologists
#15
Zeynep Aslı Kartal, Nalan Kozacı, Bülent Çekiç, İnan Beydilli, Mehmet Akçimen, Dilek Soydam Güven, İclal Erdem Toslak
OBJECTIVE: In this study, emergency physicians and on-call radiologists were compared regarding identification of fatal injuries on computed tomographic (CT) scans in patients with trauma. MATERIALS AND METHODS: Multiply injured patients who were older than 18 years and underwent CT scanning were included in the study. The CT scans were interpreted by the responsible emergency physician. At the same time, these images were also evaluated by the on-call radiologist...
August 24, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27523885/ultrasonography-in-the-emergency-department
#16
REVIEW
Micah R Whitson, Paul H Mayo
Point-of-care ultrasonography (POCUS) is a useful imaging technique for the emergency medicine (EM) physician. Because of its growing use in EM, this article will summarize the historical development, the scope of practice, and some evidence supporting the current applications of POCUS in the adult emergency department. Bedside ultrasonography in the emergency department shares clinical applications with critical care ultrasonography, including goal-directed echocardiography, echocardiography during cardiac arrest, thoracic ultrasonography, evaluation for deep vein thrombosis and pulmonary embolism, screening abdominal ultrasonography, ultrasonography in trauma, and guidance of procedures with ultrasonography...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27619651/keep-it-simple-vascular-risk-factors-and-focal-exam-findings-correctly-identify-posterior-circulation-ischemia-in-dizzy-patients
#17
Karen Chen, Andrea L C Schneider, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Dizziness is a common chief complaint of patients presenting to the Emergency Department (ED). Physicians must quickly and accurately identify patients whose etiology is most likely ischemia. Additional tools are available, but often require further training (vestibular testing) or are costly and not always readily available (magnetic resonance imaging (MRI)). This study evaluates the ability of a routine history and simple physical examination to correctly identify dizzy patients with posterior circulation ischemia, and the added utility of CT angiography (CTA)...
September 13, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27616037/effect-of-tamsulosin-on-stone-passage-for-ureteral-stones-a-systematic-review-and-meta-analysis
#18
Ralph C Wang, Rebecca Smith-Bindman, Evans Whitaker, Jersey Neilson, Isabel Elaine Allen, Marshall L Stoller, Jahan Fahimi
STUDY OBJECTIVE: Tamsulosin is recommended for patients receiving a diagnosis of a ureteral stone less than 10 mm who do not require immediate urologic intervention. Because of conflicting results from recent meta-analyses and large randomized controlled trials, the efficacy of tamsulosin is unclear. We perform a systematic review and meta-analysis to investigate the effect of tamsulosin on stone passage in patients receiving a diagnosis of ureteral stone. METHODS: MEDLINE, EMBASE, and CENTRAL databases were searched without language restriction through November 2015 for studies assessing the efficacy of tamsulosin and using a double-blind, randomized, controlled trial design...
September 7, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27617902/big-vs-small-data-and-the-generalizability-of-the-rate-of-ct-overuse-in-minor-head-injury
#19
Edward R Melnick
In an electronic health record (EHR) chart review of adult ED trauma patients receiving a head CT from 2008-2013 within 14 community EDs, Sharp et al. estimate that approximately 1/3 of computed tomography (CT) scans in head injury are likely avoidable based on the Canadian CT Head Rule (CCHR).(1) The analysis includes 27,240 adult trauma patients receiving head CTs and uses in-depth chart review of 100 random encounters with 2 independent abstractors (with high inter-rater reliability) to adjust the estimated number of avoidable CTs-the top Choosing Wisely initiative for emergency medicine...
September 12, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27480348/safely-managing-acute-osteoarthritis-in-the-emergency-department-an-evidence-based-review
#20
Scott E Young, Jason D Bothwell, Ryan M Walsh
BACKGROUND: Joint pain caused by acute osteoarthritis (OA) is a common finding in the emergency department. Patients with OA often have debilitating pain that limits their function and ability to complete their activities of daily living. In addition, OA has been associated with a high percentage of arthritis-related hospital admissions and an increased risk of all-cause mortality. Safely managing OA symptoms in these patients can present many challenges to the emergency provider. OBJECTIVES: We review the risks and benefits of available treatment options for acute OA-related pain in the emergency department...
December 2016: Journal of Emergency Medicine
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