Annals of emergency medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
Atomized lidocaine as topical anesthesia for nasogastric tube placement: A randomized, double-blind, placebo-controlled trial.
To evaluate the efficacy of topical atomized 4% lidocaine in reducing the pain associated with nasogastric tube (NGT) placement. ⋯ Atomized nasopharyngeal and oropharyngeal 4% lidocaine results in clinically and statistically significant reductions in pain during NGT placement.
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Chest pain centers in the emergency department have generally been accepted as a safe, cost-effective, and rapid approach to the evaluation, triage, and management of patients with potential acute coronary syndromes. These centers were initially designed to enhance patient care by decreasing time to treatment for acute myocardial infarction (AMI) and rapidly identifying patients with unstable angina. They also included community outreach and educational objectives designed to reduce time from the onset of chest pain to ED presentation. ⋯ New therapies for acute coronary syndromes make ED triage and risk stratification increasingly important. Although different chest pain center protocols have proved effective, all address the diagnosis and rapid treatment of acute myocardial necrosis, rest ischemia, and exercise-induced ischemia. Identifying patients with coronary artery disease in one of these stages in the spectrum of myocardial ischemia is the foundation for a successful chest pain center in the ED.
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To identify emergency department process of care measures that are significantly associated with satisfaction and willingness to return. ⋯ These data identify specific process of care measures that are determinants of patient satisfaction and willingness to return. Efforts to increase patient satisfaction and willingness to return should focus on improving ED performance on these identified process measures.
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The American Board of Emergency Medicine gathers extensive background information on emergency medicine residents and the programs in which they train. We present the third annual report on the status of US emergency medicine residency programs. [American Board of Emergency Medicine. ⋯ Ann Emerg Med. May 2000;35:481-498.]
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Practice Guideline Guideline
Serum marker analysis in acute myocardial infarction. American College of Emergency Physicians.