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ER Techniques

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153 papers 100 to 500 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
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
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
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
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
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
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
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...
July 29, 2016: Journal of Emergency Medicine
Linjie Zhang
No abstract text is available yet for this article.
September 2016: Journal of Pediatrics
Jonathan Kaufman, Shidan Tosif, Patrick Fitzpatrick, Sandy M Hopper, Penelope A Bryant, Susan M Donath, Franz E Babl
BACKGROUND: Clean catch urine (CCU) collection in precontinent children is often time-consuming, with associated collection failure. We hypothesise that stimulating cutaneous reflexes hastens voiding for CCU. METHODS: 40 children aged 1-24 months in the ED. Standard CCU was augmented with gentle suprapubic cutaneous stimulation using saline-soaked gauze (Quick-Wee method). RESULTS: 12/40 (30%) children voided within 5 min for successful CCU...
August 26, 2016: Emergency Medicine Journal: EMJ
Heather A Heaton, Ana Castaneda-Guarderas, Elliott R Trotter, Patricia J Erwin, M Fernanda Bellolio
BACKGROUND: Scribes offer a potential solution to the clerical burden and time constraints felt by health care providers. OBJECTIVES: This is a systematic review and meta-analysis to evaluate scribe effect on patient throughput, revenue, and patient and provider satisfaction. METHODS: Six electronic databases were systematically searched from inception until May 2015. We included studies where clinicians used a scribe. We collected throughput metrics, billing data, and patient/provider satisfaction data...
October 2016: American Journal of Emergency Medicine
Benjamin W Friedman
No abstract text is available yet for this article.
August 7, 2016: Annals of Emergency Medicine
Andrew D Sobel, Kalpit N Shah, Julia A Katarincic
No abstract text is available yet for this article.
October 2016: Journal of Pediatrics
Borja Gomez, Santiago Mintegi, Silvia Bressan, Liviana Da Dalt, Alain Gervaix, Laurence Lacroix
BACKGROUND: A sequential approach to young febrile infants on the basis of clinical and laboratory parameters, including procalcitonin, was recently described as an accurate tool in identifying patients at risk for invasive bacterial infection (IBI). Our aim was to prospectively validate the Step-by-Step approach and compare it with the Rochester criteria and the Lab-score. METHODS: Prospective study including infants ≤90 days with fever without source presenting in 11 European pediatric emergency departments between September 2012 and August 2014...
August 2016: Pediatrics
Erin D Bigler, Tracy J Abildskov, Naomi J Goodrich-Hunsaker, Garrett Black, Zachary P Christensen, Trevor Huff, Dawn-Marie G Wood, John R Hesselink, Elisabeth A Wilde, Jeffrey E Max
Common neuroimaging findings in mild traumatic brain injury (mTBI), including sport-related concussion (SRC), are reviewed based on computed tomography and magnetic resonance imaging (MRI). Common abnormalities radiologically identified on the day of injury, typically a computed tomographic scan, are in the form of contusions, small subarachnoid or intraparenchymal hemorrhages as well as subdural and epidural collections, edema, and skull fractures. Common follow-up neuroimaging findings with MRI include white matter hyperintensities, hypointense signal abnormalities that reflect prior hemorrhage, focal encephalomalacia, presence of atrophy and/or dilated Virchow-Robins perivascular space...
September 2016: Sports Medicine and Arthroscopy Review
Latha Ganti, Yasamin Daneshvar, Sarah Ayala, Aakash N Bodhit, Keith R Peters
BACKGROUND: Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI). METHODS: This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI...
2016: Military Medical Research
Kevin Ostrowski, Gillian Edwards, Kevin Maruno
No abstract text is available yet for this article.
August 2016: Emergency Medicine Australasia: EMA
Polly E Bijur, Purvi D Shah, David Esses
OBJECTIVE: The objective was to compare agreement between three non-invasive measures of temperature and rectal temperatures and to estimate the sensitivity and specificity of these measures to detect a rectal temperature of 38°C or higher. METHODS: We conducted a study of the diagnostic accuracy of oral, tympanic membrane (TM) and temporal artery (TA) thermometry to measure fever in an urban emergency department (ED). Data were collected from adult patients who received rectal temperature measurement...
June 22, 2016: Emergency Medicine Journal: EMJ
Gavin Denton, Laura Howard
A shortcut review of the literature was carried out to establish whether the use of apnoeic oxygenation technique during endotracheal intubation reduces the incidence of critical desaturation. Four trials were found to be directly relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that there is emerging evidence that the use of apnoeic oxygenation decreases the incidence of critical desaturation during endotracheal intubation...
July 2016: Emergency Medicine Journal: EMJ
Scott D Weingart
No abstract text is available yet for this article.
June 9, 2016: Annals of Emergency Medicine
Martha Bustos, Raman Venkataramanan, Steve Caritis
Nausea and vomiting of pregnancy (NVP) is one of the most common disorders of pregnancy. The symptoms occur predominantly during the first trimester, although in a subgroup of patients they can continue throughout the entire pregnancy and can affect the woman's quality of life. A small percentage of women develop a severe form of NVP called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Overall, the morbidity in pregnant women with NVP is significant, although it tends to be underestimated...
May 13, 2016: Autonomic Neuroscience: Basic & Clinical
2016-05-24 16:42:05
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