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ER Techniques

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211 papers 500 to 1000 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/29181532/management-of-suspected-opioid-overdose-with-naloxone-in-out-of-hospital-settings-a-systematic-review
#1
Roger Chou, P Todd Korthuis, Dennis McCarty, Phillip O Coffin, Jessica C Griffin, Cynthia Davis-O'Reilly, Sara Grusing, Mohamud Daya
Background: Naloxone is effective for reversing opioid overdose, but optimal strategies for out-of-hospital use are uncertain. Purpose: To synthesize evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility after reversal of overdose with naloxone. Data Sources: Ovid MEDLINE (1946 through September 2017), PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, U...
November 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#2
REVIEW
George Kovacs, Nicholas Sowers
Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the polytrauma patient are reviewed, with specific considerations for those presenting with traumatic brain injury, suspected c-spine injury, the contaminated airway, the agitated trauma patient, maxillofacial trauma, and the traumatized airway. An approach to airway management that considers the potential anatomic and physiologic challenges in caring for these complicated trauma patients is presented...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29162267/the-prehospital-management-of-hypothermia-an-up-to-date-overview
#3
REVIEW
Frederike J C Haverkamp, Gordon G Giesbrecht, Edward C T H Tan
BACKGROUND: Accidental hypothermia concerns a body core temperature of less than 35°C without a primary defect in the thermoregulatory system. It is a serious threat to prehospital patients and especially injured patients, since it can induce a vicious cycle of the synergistic effects of hypothermia, acidosis and coagulopathy; referred to as the trauma triad of death. To prevent or manage deterioration of a cold patient, treatment of hypothermia should ideally begin prehospital. Little effort has been made to integrate existent literature about prehospital temperature management...
November 4, 2017: Injury
https://www.readbyqxmd.com/read/29132904/straight-leg-elevation-to-rule-out-pelvic-injury
#4
Caroline Bolt, Francis O'Keeffe, Pete Finnegan, Kristofer Dickson, De Villiers Smit, Mark C Fitzgerald, Biswadev Mitra
OBJECTIVE: Pelvic x-ray is frequently used as a screening tool during initial assessment of injured patients. However routine use in the awake and alert blunt trauma patient may be questioned due to low yield. We propose a clinical tool that may avoid unnecessary imaging by examining whether the ability to straight leg raise, without pain, can rule out pelvic injury. METHODS: We conducted a prospective cohort study with the exposure variables of ability to straight leg raise and presence of pain on doing so, and presence of pelvic fracture on x-ray as the primary outcome variable...
October 9, 2017: Injury
https://www.readbyqxmd.com/read/29133539/validation-of-the-ottawa-subarachnoid-hemorrhage-rule-in-patients-with-acute-headache
#5
MULTICENTER STUDY
Jeffrey J Perry, Marco L A Sivilotti, Jane Sutherland, Corinne M Hohl, Marcel Émond, Lisa A Calder, Christian Vaillancourt, Venkatesh Thirganasambandamoorthy, Howard Lesiuk, George A Wells, Ian G Stiell
BACKGROUND: We previously derived the Ottawa Subarachnoid Hemorrhage Rule to identify subarachnoid hemorrhage (SAH) in patients with acute headache. Our objective was to validate the rule in a new cohort of consecutive patients who visited an emergency department. METHODS: We conducted a multicentre prospective cohort study at 6 university-affiliated tertiary-care hospital emergency departments in Canada from January 2010 to January 2014. We included alert, neurologically intact adult patients with a headache peaking within 1 hour of onset...
November 13, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29098983/what-domains-of-clinical-function-should-be-assessed-after-sport-related-concussion-a-systematic-review
#6
REVIEW
Nina Feddermann-Demont, Ruben J Echemendia, Kathryn J Schneider, Gary S Solomon, K Alix Hayden, Michael Turner, Jiří Dvořák, Dominik Straumann, Alexander A Tarnutzer
BACKGROUND: Sport-related concussion (SRC) is a clinical diagnosis made after a sport-related head trauma. Inconsistency exists regarding appropriate methods for assessing SRC, which focus largely on symptom-scores, neurocognitive functioning and postural stability. DESIGN: Systematic literature review. DATA SOURCES: MEDLINE, EMBASE, PsycINFO, Cochrane-DSR, Cochrane CRCT, CINAHL, SPORTDiscus (accessed July 9, 2016). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Original (prospective) studies reporting on postinjury assessment in a clinical setting and evaluation of diagnostic tools within 2 weeks after an SRC...
June 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29093119/hand-and-foot-color-change-diagnosis-and-management
#7
Dustin E Fleck, Mark F Hoeltzel
No abstract text is available yet for this article.
November 2017: Pediatrics in Review
https://www.readbyqxmd.com/read/29084761/tick-paralysis
#8
Sylvain A Lother, Laura Haley
No abstract text is available yet for this article.
October 30, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28879205/pediatric-burn-resuscitation-past-present-and-future
#9
REVIEW
Kathleen S Romanowski, Tina L Palmieri
Burn injury is a leading cause of unintentional death and injury in children, with the majority being minor (less than 10%). However, a significant number of children sustain burns greater than 15% total body surface area (TBSA), leading to the initiation of the systemic inflammatory response syndrome. These patients require IV fluid resuscitation to prevent burn shock and death. Prompt resuscitation is critical in pediatric patients due to their small circulating blood volumes. Delays in resuscitation can result in increased complications and increased mortality...
2017: Burns and trauma
https://www.readbyqxmd.com/read/29042095/can-emergency-physicians-accurately-distinguish-retinal-detachment-from-posterior-vitreous-detachment-with-point-of-care-ocular-ultrasound
#10
Nicola Baker, Richard Amini, Elaine H Situ-LaCasse, Josie Acuña, Tomas Nuño, Uwe Stolz, Srikar Adhikari
STUDY OBJECTIVE: There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound. METHODS: Single blinded cross-sectional study at an academic medical center...
October 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28987525/subgroup-analysis-of-antibiotic-treatment-for-skin%C3%A2-abscesses
#11
David A Talan, Gregory J Moran, Anusha Krishnadasan, Fredrick M Abrahamian, Frank Lovecchio, David J Karras, Mark T Steele, Richard E Rothman, William R Mower
STUDY OBJECTIVE: Two large randomized trials recently demonstrated efficacy of methicillin-resistant Staphylococcus aureus (MRSA)-active antibiotics for drained skin abscesses. We determine whether outcome advantages observed in one trial exist across lesion sizes and among subgroups with and without guideline-recommended antibiotic indications. METHODS: We conducted a planned subgroup analysis of a double-blind, randomized trial at 5 US emergency departments, demonstrating superiority of trimethoprim-sulfamethoxazole (320/1,600 mg twice daily for 7 days) compared with placebo for patients older than 12 years with a drained skin abscess...
October 4, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28958987/tablet-based-patient-centered-decision-support-for-minor-head-injury-in-the-emergency-department-pilot-study
#12
Navdeep Singh, Erik Hess, George Guo, Adam Sharp, Brian Huang, Maggie Breslin, Edward Melnick
BACKGROUND: The Concussion or Brain Bleed app is a clinician- and patient-facing electronic tool to guide decisions about head computed tomography (CT) use in patients presenting to the emergency department (ED) with minor head injury. This app integrates a patient decision aid and clinical decision support (using the Canadian CT Head Rule, CCHR) at the bedside on a tablet computer to promote conversations around individualized risk and patients' specific concerns within the ED context...
September 28, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28931507/corticosteroids-for-sore-throat-a-clinical-practice-guideline
#13
Bert Aertgeerts, Thomas Agoritsas, Reed A C Siemieniuk, Jako Burgers, Geertruida E Bekkering, Arnaud Merglen, Mieke van Driel, Mieke Vermandere, Dominique Bullens, Patrick Mbah Okwen, Ricardo Niño, Ann van den Bruel, Lyubov Lytvyn, Carla Berg-Nelson, Shunjie Chua, Jack Leahy, Jennifer Raven, Michael Weinberg, Behnam Sadeghirad, Per O Vandvik, Romina Brignardello-Petersen
No abstract text is available yet for this article.
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28843310/the-quick-wee-infant-urine-collection-method
#14
Antoine Tran
No abstract text is available yet for this article.
September 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28826651/what-s-new-in-ankle-fractures
#15
REVIEW
Matthew J Toth, Richard S Yoon, Frank A Liporace, Kenneth J Koval
The diagnosis and treatment of ankle fractures has evolved considerably over the past two decades. Recent topics of interest have included indications for operative treatment of isolated lateral malleolus fractures, need for fixation of the posterior malleolus, utilization of the posterolateral approach, treatment of the syndesmosis, and the potential role of fibular nailing. In this update, we concisely review these topics and what to expect in the future literature.
October 2017: Injury
https://www.readbyqxmd.com/read/28811122/acute-kidney-injury-after-computed-tomography-a-meta-analysis
#16
REVIEW
Ryan D Aycock, Lauren M Westafer, Jennifer L Boxen, Nima Majlesi, Elizabeth M Schoenfeld, Raveendhara R Bannuru
STUDY OBJECTIVE: Computed tomography (CT) is an important imaging modality used in the diagnosis of a variety of disorders. Imaging quality may be improved if intravenous contrast is added, but there is a concern for potential renal injury. Our goal is to perform a meta-analysis to compare the risk of acute kidney injury, need for renal replacement, and total mortality after contrast-enhanced CT versus noncontrast CT. METHODS: We searched MEDLINE (PubMed), the Cochrane Library, CINAHL, Web of Science, ProQuest, and Academic Search Premier for relevant articles...
August 12, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28806797/dexamethasone-did-not-increase-resolution-of-acute-sore-throat-symptoms-at-24-hours
#17
Thomas Fekete
No abstract text is available yet for this article.
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28712606/effectiveness-of-apneic-oxygenation-during-intubation-a-systematic-review-and-meta-analysis
#18
REVIEW
Lucas Oliveira J E Silva, Daniel Cabrera, Patricia Barrionuevo, Rebecca L Johnson, Patricia J Erwin, M Hassan Murad, M Fernanda Bellolio
STUDY OBJECTIVE: We conduct a systematic review and meta-analysis to evaluate the effectiveness of apneic oxygenation during emergency intubation. METHODS: We searched Ovid MEDLINE, Ovid EMBASE, Ovid CENTRAL, and Scopus databases for randomized controlled trials and observational studies from 2006 until July 2016, without language restrictions. Gray literature, clinicaltrials.gov, and reference lists of articles were hand searched. We conducted a meta-analysis with random-effects models to evaluate first-pass success rates, incidence of hypoxemia, and lowest peri-intubation SpO2 between apneic oxygenation and standard oxygenation cases...
October 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#19
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28684195/apneic-oxygenation-during-intubation-in-the-emergency-department-and-during-retrieval-a-systematic-review-and-meta-analysis
#20
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Elyse Bond, Leigh D White
BACKGROUND: Hypoxemia increases the risk of intubation markedly. Such concerns are multiplied in the emergency department (ED) and during retrieval where patients may be unstable, preparation or preoxygenation time limited and the environment uncontrolled. Apneic oxygenation is a promising means of preventing hypoxemia in this setting. AIM: To test the hypothesis that apnoeic oxygenation reduces the incidence of hypoxemia during endotracheal intubation in the ED and during retrieval...
October 2017: American Journal of Emergency Medicine
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