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ER Techniques

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274 papers 500 to 1000 followers ER Techniques
By David Rhine MD FRCPC. Emergency medicine. Special interest in concussion management.
Brit Long, Alex Koyfman, Michael Gottlieb
Endotracheal intubation is a common intervention in the emergency department (ED) and prehospital setting. Direct visualization of endotracheal tube (ETT) placement through the vocal cords is limited at times, and esophageal intubation can be dangerous if not recognized.1 Therefore, additional methods (e.g. lung auscultation, esophageal detector devices, capnography) are necessary for confirmation of tube placement. This article is protected by copyright. All rights reserved.
May 2, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Michael Gottlieb, Alex Koyfman, Brit Long
Epistaxis is a common reason for patients to present to the Emergency Department (ED), reflecting 1 out of every 200 ED visits in the United States.1 While many cases of epistaxis are self-limiting, those requiring medical treatment can be associated with significant time and healthcare costs.2 This article is protected by copyright. All rights reserved.
April 1, 2019: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Adrian J Stanley, Loren Laine
Upper gastrointestinal bleeding (UGIB) is a common medical emergency, with a reported mortality of 2-10%. Patients identified as being at very low risk of either needing an intervention or death can be managed as outpatients. For all other patients, intravenous fluids as needed for resuscitation and red cell transfusion at a hemoglobin threshold of 70-80 g/L are recommended. After resuscitation is initiated, proton pump inhibitors (PPIs) and the prokinetic agent erythromycin may be administered, with antibiotics and vasoactive drugs recommended in patients who have cirrhosis...
March 25, 2019: BMJ: British Medical Journal
François Dépret, W Frank Peacock, Kathleen D Liu, Zubaid Rafique, Patrick Rossignol, Matthieu Legrand
PURPOSE: To review the mechanisms of action, expected efficacy and side effects of strategies to control hyperkalemia in acutely ill patients. METHODS: We searched MEDLINE and EMBASE for relevant papers published in English between Jan 1, 1938, and July 1, 2018, in accordance with the PRISMA Statement using the following terms: "hyperkalemia," "intensive care," "acute kidney injury," "acute kidney failure," "hyperkalemia treatment," "renal replacement therapy," "dialysis," "sodium bicarbonate," "emergency," "acute...
February 28, 2019: Annals of Intensive Care
Burak Bekgoz, Isa Kilicaslan, Fikret Bildik, Ayfer Keles, Ahmet Demircan, Onur Hakoglu, Gulhan Coskun, Huseyin Avni Demir
OBJECTIVE: Dyspnea is a common Emergency Department (ED) symptom requiring prompt diagnosis and treatment. The bedside lung ultrasonography in emergency (BLUE) protocol is defined as a bedside diagnostic tool in intensive care units. The aim of this study was to investigate the test performance characteristics of the BLUE-protocol ultrasonography in ED patients presenting with acute dyspnea. METHOD: This study was performed as a prospective observational study at the ED of a tertiary care university hospital over a 3-month period...
February 20, 2019: American Journal of Emergency Medicine
Mikio Nakajima, Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: The effects of hyperbaric oxygen therapy (HBOT) on mortality or morbidity in patients with carbon monoxide (CO) poisoning remain unknown. We examined the effects of HBOT on CO poisoning and further strived to delineate its inherent effects on specific subgroups of patients using a nationwide inpatient database. METHODS: We identified adult patients with CO poisoning who were registered in the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2016...
February 10, 2019: American Journal of Emergency Medicine
Emily W Stewart, Kerry P Spearing, Riyad B Abu-Laban
CLINICAL QUESTION: Is bougie use associated with increased first-pass success in emergency department (ED) intubations?Article chosen: Driver et al. The Bougie and First-Pass Success in the Emergency Department. Annals of Emerg Med 2017;70(4):473-478. OBJECTIVE: To compare data and assess whether bougie use is independently associated with first-pass success in ED intubations.
February 21, 2019: CJEM
Kelsey A Miller, Gary Andolfatto, James R Miner, John H Burton, Baruch S Krauss
We update an evidence-based clinical practice guideline for the administration of propofol for emergency department procedural sedation. Both the unique considerations of using this drug in the pediatric population and the substantial new research warrant revision of the 2007 advisory. We discuss the indications, contraindications, personnel requirements, monitoring, dosing, coadministered medications, and adverse events for propofol sedation.
February 4, 2019: Annals of Emergency Medicine
Scott J Millington, Manoj M Lalu, Michel Boivin, Seth Koenig
The insertion of a subclavian central venous catheter is generally associated with a high rate of success and a favorable risk profile. The use of ultrasound for procedural guidance has been demonstrated to further increase the rate of success and reduce the risk of specific mechanical complications, especially in patients with difficult surface anatomy. Many individual ultrasound techniques have been described in the literature; this article presents a systematic approach for incorporating these tools into bedside practice and includes a series of illustrative figures and narrated video presentations to demonstrate the techniques described...
January 2, 2019: Chest
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
No abstract text is available yet for this article.
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...
December 4, 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...
February 2019: 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...
November 6, 2018: Annals of Internal Medicine
2018-10-27 14:30:36
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