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ER Techniques

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265 papers 500 to 1000 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
Michael Gottlieb, Dallas Holladay, Gary D Peksa
BACKGROUND: Ocular complaints are common presentations to the Emergency Department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point-of-care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available. However, prior studies were limited by small sample sizes, resulting in wide ranges of potential accuracy...
January 13, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Christian Backer Mogensen, Malene Bue Vilhelmsen, Johanne Jepsen, Lilian Keene Boye, Maiken Hjuler Persson, Florence Skyum
BACKGROUND: A new generation of ear thermometers with preheated tips and several measurements points should allow a more precise temperature measurement. The aim of the study was to evaluate if the ear temperature measured by this ear thermometer can be used to screen for fever and whether the thermometer is in agreement with the rectal temperature and if age, use of hearing devices or time after admission influences the temperature measurements. METHODS: Open cross-sectional clinical single site study patients, > 18 years old, who were acutely admitted to the short stay unit at the ED...
December 3, 2018: BMC Emergency Medicine
Mark J Siedner, Ethan Tumarkin, Isaac I Bogoch
No abstract text is available yet for this article.
November 29, 2018: BMJ: British Medical Journal
Tina Hu, Larry Nijmeh, Adam Pyle
No abstract text is available yet for this article.
November 26, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Corey Heitz, Justin Morgenstern, Christopher Bond, William K Milne
Ketamine has been studied as an alternative to opioids for acute pain in the emergency department setting. This review compares the effectives of intravenous ketamine at a dose of <0.5mg/kg to opioids for acute pain in adult patients. Measurements were taken within 60 minutes of administration. Ketamine was found to have similar effectiveness to opioids. Increased, but short-lived, side effects were seen with ketamine.
November 27, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Daniel S Kowalsky, Allan B Wolfson
Post-herpetic neuralgia is a painful condition of persistent chronic pain following acute reactivation of varicella zoster virus. The review defines PHN as persisting or recurring pain at the site of shingles at least one month after the onset of the acute rash. The incidence of shingles increases with age, almost doubling in each decade after 50 years of age. Of these cases, roughly 20% go on to develop PHN, with age again being the strongest risk factor.1 The pain of PHN is frequently debilitating and can significantly affect quality of life...
November 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Angela Lowenstern, Sana M Al-Khatib, Lauren Sharan, Ranee Chatterjee, Nancy M Allen LaPointe, Bimal Shah, Ethan D Borre, Giselle Raitz, Adam Goode, Roshini Yapa, J Kelly Davis, Kathryn Lallinger, Robyn Schmidt, Andrzej S Kosinski, Gillian D Sanders
Background: The comparative safety and effectiveness of treatments to prevent thromboembolic complications in atrial fibrillation (AF) remain uncertain. Purpose: To compare the effectiveness of medical and procedural therapies in preventing thromboembolic events and bleeding complications in adults with nonvalvular AF. Data Sources: English-language studies in several databases from 1 January 2000 to 14 February 2018. Study Selection: Two reviewers independently screened citations to identify comparative studies of treatments to prevent stroke in adults with nonvalvular AF who reported thromboembolic or bleeding complications...
October 30, 2018: Annals of Internal Medicine
Ardavan Khoshnood
Supplemental oxygen (O2 ) therapy in patients with chest pain has been a cornerstone in the treatment of suspected myocardial infarction (MI). Recent randomized controlled trials have, however, shown that supplemental O2 therapy has no positive nor negative effects on cardiovascular functions, mortality, morbidity or pain in normoxic patients with suspected MI and foremost patients with ST Elevation Myocardial Infarction (STEMI). O2 therapy in normoxic STEMI patients should therefore be omitted. More studies are needed in discussing hemodynamically unstable STEMI patients, as well as patients with non-STEMI, unstable angina and other emergency conditions...
October 20, 2018: BMC Emergency Medicine
Krista Brucker, Carter Duggan, Joseph Niezer, Kyle Roseberry, Helen Le-Niculescu, Alexander B Niculescu, Jeffrey A Kline
BACKGROUND: Emergency departments (ED) are the first line of evaluation for patients at risk and in crisis, with or without overt suicidality (ideation, attempts). Currently employed triage and assessments methods miss some of the individuals who subsequently become suicidal. The Convergent Functional Information for Suicidality (CFI-S) 22-item checklist of risk factors, which does not ask directly about suicidal ideation, has demonstrated good predictive ability for suicidality in previous studies in psychiatrict patients but has not been tested in the real-world setting of EDs...
October 30, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shannon M Fernando, Alexandre Tran, Wei Cheng, Bram Rochwerg, Monica Taljaard, Venkatesh Thiruganasambandamoorthy, Kwadwo Kyeremanteng, Jeffrey J Perry
OBJECTIVE: The HEART score has been proposed for emergency department (ED) prediction of major adverse cardiac events (MACE). We sought to summarize all studies assessing the prognostic accuracy of the HEART score for prediction of MACE in adult ED patients presenting with chest pain. METHODS: We searched MEDLINE, PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews from inception through May 2018 and included studies using the HEART score for the prediction of short-term MACE in adult patients presenting to the ED with chest pain...
October 29, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Stephen A Martin, Lisa M Chiodo, Jordon D Bosse, Amanda Wilson
Buprenorphine has been used internationally for the treatment of opioid use disorder (OUD) since the 1990s and has been available in the United States for more than a decade. Initial practice recommendations were intentionally conservative, were based on expert opinion, and were influenced by methadone regulations. Since 2003, the American crisis of OUD has dramatically worsened, and much related empirical research has been undertaken. The findings in several important areas conflict with initial clinical practice that is still prevalent...
October 23, 2018: Annals of Internal Medicine
David H Cisewski, Cynthia Santos, Alex Koyfman, Brit Long
INTRODUCTION: Opioid use disorder (OUD) is increasing in prevalence throughout the world, with approximately three million individuals in the United States affected. Buprenorphine is a medication designed, researched, and effectively used to assist in OUD recovery. OBJECTIVE: This narrative review discusses an approach to initiating buprenorphine in the emergency department (ED) for opioid-abuse recovery. DISCUSSION: Buprenorphine is a partial mu-opioid receptor agonist with high affinity and low intrinsic activity...
October 11, 2018: American Journal of Emergency Medicine
Alejandra Vasquez, Marina Gaínza-Lein, Iván Sánchez Fernández, Nicholas S Abend, Anne Anderson, J Nicholas Brenton, Jessica L Carpenter, Kevin Chapman, Justice Clark, William D Gaillard, Tracy Glauser, Joshua Goldstein, Howard P Goodkin, Yi-Chen Lai, Tobias Loddenkemper, Tiffani L McDonough, Mohamad A Mikati, Anuranjita Nayak, Eric Payne, James Riviello, Dmitry Tchapyjnikov, Alexis A Topjian, Mark S Wainwright, Robert C Tasker
OBJECTIVE: We aimed to evaluate and compare the status epilepticus treatment pathways used by pediatric status epilepticus research group (pSERG) hospitals in the United States and the American Epilepsy Society (AES) status epilepticus guideline. METHODS: We undertook a descriptive analysis of recommended timing, dosing, and medication choices in 10 pSERG hospitals' status epilepticus treatment pathways. RESULTS: One pathway matched the timeline in the AES guideline; nine pathways described more rapid timings...
September 2018: Pediatric Neurology
Anne Kristine Servais Iversen, Michael Kristensen, Rebecca Monett Østervig, Lars Køber, György Sölétormos, Jakob Lundager Forberg, Jesper Eugen-Olsen, Lars Simon Rasmussen, Morten Schou, Kasper Karmark Iversen
OBJECTIVE: To compare the Danish Emergency Process Triage (DEPT) with a quick clinical assessment (Eyeball triage) as predictors of short-term mortality in patients in the emergency department (ED). METHODS: The investigation was designed as a prospective cohort study conducted at North Zealand University Hospital. All patient visits to the ED from September 2013 to December 2013 except minor injuries were included. DEPT was performed by nurses. Eyeball triage was a quick non-systematic clinical assessment based on patient appearance performed by phlebotomists...
October 16, 2018: Emergency Medicine Journal: EMJ
Catherine M Lunter, Ellen L Carroll, Charlotte Housden, Joanne Outtrim, Faye Forsyth, Annie Rivera, Chris Maimaris, Adrian Boyle, Barbara J Sahakian, David K Menon, Virginia Fj Newcombe
OBJECTIVE: Despite mild traumatic brain injury (mTBI) accounting for 80% of head injury diagnoses, recognition of individuals at risk of cognitive dysfunction remains a challenge in the acute setting. The objective of this study was to evaluate the feasibility and potential role for computerised cognitive testing as part of a complete ED head injury assessment. METHODS: mTBI patients (n = 36) who incurred a head injury within 24 h of presentation to the ED were compared to trauma controls (n = 20) and healthy controls (n = 20) on tests assessing reaction time, speed and attention, episodic memory, working memory and executive functioning...
September 3, 2018: Emergency Medicine Australasia: EMA
Abdullah Bakhsh, Michael Ritchie
Tracheal intubation is a critical step in securing the patient's airway in a variety of emergent and non-emergent settings. Difficulties and complications may arise with this procedure, and alternative laryngoscopes that use video technology have been designed to improve visibility when airway difficulty is predicted or encountered. These devices may be flexible or rigid in design for the purpose of assisting in intubations, especially expected difficult intubations. Video laryngoscopes have been advertised as being able to reduce difficulty, failure, trauma and other complications compared with direct laryngoscopy...
October 15, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
K Hawrylyshyn, S L McLeod, J Thomas, Catherine Varner
CLINICIAN'S CAPSULE What is known about the topic? Methotrexate is widely accepted as first-line treatment of non-ruptured ectopic pregnancy and may be considered for women with a suspected ectopic pregnancy. What did this study ask? What are the outcomes of pregnant women with suspected ectopic pregnancy who received methotrexate as first-line treatment? What did this study find? Of patients treated with methotrexate, 18% went on to require surgical management, with 11.2% having ruptured on surgical evaluation...
October 8, 2018: CJEM
Daniel J Corwin, Kathleen J Propert, Joseph J Zorc, Mark R Zonfrillo, Douglas J Wiebe
BACKGROUND: Concussion guidelines recommend a vestibular and oculomotor (VOM) examination be performed for all patients with concern for concussion, however the feasibility of performing testing is unknown. We aimed to measure rates of exam performance after implementation of training and support tools in a pediatric emergency department. METHODS: We conducted a retrospective study of patients age 6 to 18 years old presenting over a 12-month period. Charts were obtained via natural language processing, where concussion was suggested as a diagnosis in the electronic health record, and then manually reviewed to record patient and provider factors...
September 5, 2018: American Journal of Emergency Medicine
Peter S Graves, Stephen R Graves, Tanvir Minhas, Rebecca E Lewinson, Isabelle A Vallerand, Ryan T Lewinson
BACKGROUND: Emergency department efficiency is a priority across Canada. In the United States, scribes may increase the number of patients seen per hour per physician; however, Canadian data are lacking. We sought to implement scribes in a Canadian emergency department with the hypothesis that scribes would increase the number of patients seen per hour per physician. METHODS: We conducted a 4-month quality improvement pilot study in a community emergency department in Ottawa, Ontario...
July 2018: CMAJ Open
Roberto C Portela, Andrew C Miller
Idiopathic facial paralysis (aka Bell's Palsy) is the most common cause of unilateral facial paralysis.1 Maximal disability occurs within 48-72 hours, with symptoms involving both the upper and lower face.1 Patients may exhibit flattening of the forehead and nasolabial fold on the affected side, with the forehead remaining flat on the affected side when the patient raises his/her eyebrows. Additional symptoms may include poor eyelid closure, eye pain, blurred vision, posterior auricular pain, otalgia, hyperacusis, and taste disturbances...
September 4, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
2018-09-07 17:01:05
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