The American journal of emergency medicine
-
Randomized Controlled Trial Comparative Study
Comparing first pass success of Channeled versus Non-channeled KingVision video laryngoscopes in patients presenting to the emergency department - A randomized control study.
In modern times, the emergency physician (EP) has access to a host of video laryngoscopes (VL). There are different makes, models, angulations in the blades provided by different VLs. The blades may be channeled or non-channeled. In busy emergency departments (ED), ease and speed of intubations in managing the emergent airways may impact the outcome for the patient. ⋯ We found the non-channeled blades to have a significantly higher percentage of first pass success. Performance with respect to time to intubate was similar between the two. We recommend using the non-channeled KVVL for intubations in the EDs.
-
Caring for older adults in the Emergency Department demands compassion, expertise, and adaptability to address the intricate medical and emotional needs of this vulnerable population. Key geriatric emergency medicine articles from 2023 highlight the evolving landscape of this field: updates to the Beers Criteria for potentially inappropriate medications, medications most implicated in causing delirium, geriatric trauma centers, behavioral problems in persons with dementia, geriatric syndrome detection, and emergency department (ED) process outcomes in geriatric EDs. As healthcare organizations shift to focus on the larger continuum of care that extends beyond the ED visit, we also highlight a novel program from the Veterans Affairs bringing former military medics to the home to improve outcomes after ED discharge. This review highlights practice-changing updates to improve the management of older adults in the ED.
-
Comparative Study
Assessing the evolution of pre-hospital combat casualty care: A comparative study of two conflicts a decade apart.
Combat casualty care has advanced significantly with the implementation of evidence-based protocols designed to lower combat-related mortality. Over the last decade, two major urban conflicts in southern Israel have challenged the evolving military trauma system. This study aimed to assess differences in prehospital care and compare the outcomes of aeromedically evacuated casualties from the 2014 and 2023 conflicts. ⋯ Over the past decade, there has been a decline in prehospital airway interventions and thoracostomies, coupled with an increase in early blood transfusions. Despite greater injury severity, mortality rates have remained stable. Although not statistically significant, lower mortality rates were recorded among the severely and critically injured. These findings support the "less is more" approach in modern prehospital combat casualty care.
-
Previous self-harm attempts are a known risk factor for subsequent suicide completion in adults but is unestablished among adolescents and young adults. Our objective was to determine the mortality rate for patients 10-24 years of age following discharge from the hospital after a non-lethal, intentional overdose. ⋯ Our observed mortality was lower compared to other studies (0.7 % - 13.3 %), which may have been due to protective factors (e.g., multidisciplinary evaluations) built into the institutional protocols at this center. Future studies will attempt to qualitatively and quantitatively identify individual- and system- level mechanisms in the pathway between self-harm and long-term health outcomes.