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ER Techniques

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220 papers 500 to 1000 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
https://www.readbyqxmd.com/read/29431171/the-upgoing-thumb-sign-an-interobserver-intraobserver-reliability-study
#1
Shahram Abootalebi, Mahmoud Reza Azarpazhooh, Luciano Sposato, Vladimir Hachinski
Background: The upgoing thumb sign as a subtle clinical finding of upper motor neuron involvement has been frequently reported in patients with TIAs and minor strokes. This study was designed to show the method of examination and interpretation and the interobserver/intraobserver reliability. Methods: The thumb sign was elicited in TIA/minor strokes or stroke mimics. After obtaining the participant's permission, the examinations were recorded. Two independent neurologists reviewed all patients for the possibility of an upgoing thumb sign...
December 2017: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29433802/chest-ultrasonography-for-the-emergency-diagnosis-of-traumatic-pneumothorax-and-haemothorax-a-systematic-review-and-meta-analysis
#2
REVIEW
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Erikson Kaszubowski, Rosemeri Maurici
OBJECTIVE: To assess the diagnostic of the chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax in adults. STUDY DESIGN: Systematic review and meta-analysis. METHODS: PubMed, EMBASE, Scopus, Web of Science and LILACS (up to 2016) were systematically searched for prospective studies on the diagnostic accuracy of ultrasonography for pneumothorax and haemothorax in adult trauma patients. The references of other systematic reviews and the included studies were checked for further articles...
February 8, 2018: Injury
https://www.readbyqxmd.com/read/29395284/safety-and-efficacy-of-intravenous-lidocaine-for-pain-management-in-the-emergency-department-a-systematic-review
#3
REVIEW
Lucas Oliveira J E Silva, Kristin Scherber, Daniel Cabrera, Sergey Motov, Patricia J Erwin, Colin P West, M Hassan Murad, M Fernanda Bellolio
STUDY OBJECTIVE: We evaluate the safety and efficacy of intravenous lidocaine in adult patients with acute and chronic pain who are undergoing pain management in the emergency department (ED). METHODS: We searched Ovid CENTRAL, Ovid EMBASE, and Ovid MEDLINE databases for randomized controlled trials and observational studies from inception to January 2017. Efficacy outcomes included reduction in pain scores from baseline to postintervention and need for rescue analgesia...
January 29, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29351926/bet-1-is-routine-irrigation-of-a-cutaneous-abscess-necessary
#4
Joshua Badour, Matt Singh, Jeffrey Jones
A short cut review was carried out to establish whether the addition of irrigation of the abscess cavity improved outcomes after incision and drainage of a cutaneous abscess. One paper 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 this paper are tabulated. It is concluded that in adult patients with cutaneous abscesses routine irrigation during incision and drainage does not improve clinical outcomes...
February 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29307765/point-of-care-wrist-ultrasonography-in-trauma-patients-with-ulnar-sided-pain-and-instability
#5
Sun Hwa Lee, Seong Jong Yun
OBJECTIVE: We evaluated the effectiveness of point-of-care wrist ultrasonography compared with 3T-magnetic resonance imaging (MRI) for diagnosing triangular fibrocartilage complex (TFCC) injuries in trauma patients with ulnar-sided pain and instability. Moreover, we assessed the inter-observer variability between an emergency physician and a musculoskeletal radiology fellow. MATERIAL AND METHODS: A prospective cross-sectional study was conducted in an emergency department; patients with ulnar-sided sprain and instability were recruited...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#6
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29279177/using-a-rubber-strip-test-to-classify-swollen-fingers-for-ring-removal
#7
LETTER
Chao Cui, Rong-Ming Zhang
No abstract text is available yet for this article.
December 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29268997/what-to-do-after-you-cut-recommendations-for-abscess-management-in-the-emergency-setting
#8
Michael Gottlieb, Gillian Schmitz, Andrew Grock, Jessica Mason
No abstract text is available yet for this article.
January 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29239753/the-use-of-intranasal-analgesia-for-acute-pain-control-in-the-emergency-department-a-literature-review
#9
REVIEW
Billy Sin, Jennifer Wiafe, Christine Ciaramella, Luis Valdez, Sergey M Motov
BACKGROUND: Traditional routes for administration of pain medications include oral (PO), intravenous (IV), or intramuscular routes (IM). When these routes are not feasible, the intranasal (IN) route may be considered. The objectives of this evidence-based review were: to review the literature which compared the safety and efficacy of IN analgesia to traditional routes and to determine if IN analgesia should be considered over traditional routes for acute pain control in the ED. METHODS: The MEDLINE and EMBASE databases from July 1970 to July 2017 were searched...
February 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29181532/management-of-suspected-opioid-overdose-with-naloxone-in-out-of-hospital-settings-a-systematic-review
#10
REVIEW
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...
December 19, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
January 2018: Annals of Emergency Medicine
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