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ER Techniques

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201 papers 500 to 1000 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/28987525/subgroup-analysis-of-antibiotic-treatment-for-skin%C3%A2-abscesses
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28647137/apneic-oxygenation-reduces-the-incidence-of-hypoxemia-during-emergency-intubation-a-systematic-review-and-meta-analysis
#11
REVIEW
Ivan Pavlov, Sofia Medrano, Scott Weingart
STUDY OBJECTIVE: Apneic oxygenation has been advocated for the prevention of hypoxemia during emergency endotracheal intubation. Because of conflicting results from recent trials, the efficacy of apneic oxygenation remains unclear. We performed a systematic review and meta-analysis to investigate the effect of apneic oxygenation on the incidence of clinically significant hypoxemia during emergency endotracheal intubation. METHODS: MEDLINE, EMBASE, and PubMed databases were searched without language and time restrictions for studies of apneic oxygenation performed in a critical care setting...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28623005/pre-oxygenation-implications-in-emergency-airway-management
#12
REVIEW
Ali Pourmand, Chelsea Robinson, Kelsey Dorwart, Francis O'Connell
Transient oxygen desaturation during emergency department intubation is an event with potentially devastating consequences. Pre-oxygenation is an important means of increasing a patient's oxygen reserve and duration of safe apnea prior to intubation. In the emergent setting, important modifications to pre-oxygenation techniques need to be considered to best manage critically ill patients. In this review, we discuss recent updates in pre-oxygenation techniques and evaluate the evidence supporting both commonly used and newly emerging techniques for pre-oxygenation, assessing nature and level of illness, the best delivery method of oxygen, using delayed sequence intubation in patients who cannot tolerate non-invasive pre-oxygenation and using apneic oxygenation via nasal cannula and non-rebreather mask during intubation...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28601266/emergency-physician-use-of-cognitive-strategies-to-manage-interruptions
#13
Raj M Ratwani, Allan Fong, Josh S Puthumana, Aaron Z Hettinger
STUDY OBJECTIVE: The purpose of this study is to examine whether emergency physicians use strategies to manage interruptions during clinical work. Interruption management strategies include immediately engaging the interruption by discontinuing the current task and starting the interruption, continuing the current task while engaging the interruption, rejecting the interruption, or delaying the interruption. METHODS: An observational time and motion study was conducted in 3 different urban, academic emergency departments with 18 attending emergency physicians...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28601276/managing-patients-with-nontraumatic-severe-rapid-onset-headache
#14
REVIEW
Jonathan A Edlow
No abstract text is available yet for this article.
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28302612/difficult-lumbar-puncture-pitfalls-and-tips-from-the-trenches
#15
REVIEW
P A Hudgins, A J Fountain, P R Chapman, L M Shah
Lumbar puncture has, for many years, been the responsibility of the internal medicine physician or the neurologist. As more patients have undergone spine surgery and with the current increase in body mass index of the general population, the radiologist has been consulted with increasing frequency to perform lumbar puncture with fluoroscopic guidance. Radiology, in fact, is now the dominant overall provider of lumbar puncture procedures. The procedure is more difficult when the needle length increases, and if fluoroscopy is used, landmarks are more difficult to visualize with increasing subcutaneous fat...
July 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28552271/comparing-the-success-rates-of-standard-and-modified-valsalva-maneuvers-to-terminate-psvt-a-randomized-controlled-trial
#16
Şeref Kerem Çorbacıoğlu, Emine Akıncı, Yunsur Çevik, Halit Aytar, Mehmet Veysel Öncül, Sedat Akkan, Hüseyin Uzunosmanoğlu
PURPOSE: The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). METHODOLOGY: This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients...
May 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28527643/parental-knowledge-and-recall-of-concussion-discharge-instructions
#17
Danny George Thomas, Lia Bradley, Ashley Servi, Suzanne Reilly, Jennifer Niskala Apps, Michael McCrea, Thomas Hammeke
INTRODUCTION: Children increasingly are being seen in the emergency department for a concussion, or mild traumatic brain injury (mTBI). A key aim of the ED visit is to provide discharge advice that can help parents to identify an evolving neurosurgical crisis, facilitate recovery, and prevent reinjury. The present study examined parents' knowledge of symptoms and recall of discharge instructions after their adolescent's mTBI and the effect of supplementing written discharge instructions with verbal instruction and reinforcement...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#18
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28506329/what-to-do-when-a-patient-wants-to-record-a-patient-physician-interaction-in-the-emergency-department
#19
Brodie Nolan, Alun Ackery, Bryan Au
Recent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, patient privacy is highly regulated by provincial legislation, although patients themselves have little in the way of laws or regulations to observe. Patients taking video recordings of their own medical care does not currently fall under any of the provincial privacy laws. With no such governance for the general public, patients generally have greater freedom to record a patient-physician interaction...
May 16, 2017: CJEM
https://www.readbyqxmd.com/read/28406879/physical-examination-of-the-knee-meniscus-cartilage-and-patellofemoral-conditions
#20
Robert D Bronstein, Joseph C Schaffer
The knee is one of the most commonly injured joints in the body. Its superficial anatomy enables diagnosis of the injury through a thorough history and physical examination. Examination techniques for the knee described decades ago are still useful, as are more recently developed tests. Proper use of these techniques requires understanding of the anatomy and biomechanical principles of the knee as well as the pathophysiology of the injuries, including tears to the menisci and extensor mechanism, patellofemoral conditions, and osteochondritis dissecans...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
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