Annals of emergency medicine
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Randomized Controlled Trial Clinical Trial
Real-time ultrasound-guided femoral vein catheterization during cardiopulmonary resuscitation.
To compare the use of real-time-ultrasound guidance with the standard landmark-oriented approach for obtaining femoral vein catheterization in patients requiring intravenous access during CPR. ⋯ Real-time ultrasound-guided femoral vein catheterization was faster and produced a lower rate of inadvertent arterial catheterization and a higher rate of success during CPR than the standard landmark-oriented approach. Also, ultrasound demonstrated that palpable femoral pulsation during CPR is venous rather than arterial.
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Review Comparative Study
Ultrasound in the evaluation and management of blunt abdominal trauma.
Failure to detect intraabdominal injury in the patient with blunt trauma may result in significant morbidity and mortality. The diagnosis of abdominal injury remains a clinical challenge. Presented here is a review of recent literature comparing ultrasound with diagnostic peritoneal lavage and computed tomography in the evaluation of blunt abdominal trauma.
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Randomized Controlled Trial Clinical Trial
Ultrasound for the detection of foreign bodies in human tissue.
To determine the accuracy of detection of wood and plastic foreign bodies in human tissue by relatively inexperienced clinicians using typical ultrasound equipment. ⋯ Ultrasound is imperfect but may be useful in screening for superficial foreign bodies in human tissue. Clinical utility in the ED setting remains to be tested.
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We anticipate that over the next few years, emergency physician use of emergency department ultrasound will become the standard of care. However, many EDs are hampered in their efforts to gain hospital approval for emergency physician use of ultrasound because of the lack of publicized information regarding the goals of such use, the scope of emergency physician ultrasound privileges, emergency physician ultrasound credentialing criteria, and ED ultrasound quality-improvement plans. In this article we address these issues and provide an example of a proposal used successfully to gain hospital approval for ED use of ultrasound by emergency physicians.
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Clinical Trial Controlled Clinical Trial
Incision and drainage of cutaneous abscesses is not associated with bacteremia in afebrile adults.
To determine the prevalence of bacteremia associated with incision and drainage (I&D) of cutaneous abscesses in afebrile adult emergency department patients. Such information has implications for the ED management of immunocompromised patients, patients with history of endocarditis, and patients with prosthetic appliances such as heart valves and artificial joints. ⋯ I&D of localized cutaneous abscesses in afebrile adults is unlikely to result in transient bacteremia. Larger studies are needed to determine whether routine antibiotic prophylaxis is necessary for afebrile patients undergoing I&D.