The American journal of emergency medicine
-
Facial trauma and orbital fractures are common reasons for ophthalmology consultation in the emergency department (ED). The purpose of this study is to assess intervention rates and evaluate the acuity of ophthalmology consultation for orbital fractures in the ED. ⋯ Orbital fractures can be associated with severe ocular complications. Most cases, however, do not require emergent evaluation by an ophthalmologist. We propose the South Texas Orbital Fracture Protocol (STOP) for proper assessment and triaging of orbital fractures in the ED. While this clinical decision-making tool requires validation, it may offer improved healthcare efficiency, reduced costs, fewer unnecessary inter-facility transfers, and less burnout for ophthalmology residents.
-
Tubo-ovarian abscess (TOA) is a rare but serious condition that carries with it a high rate of morbidity and even mortality. ⋯ An understanding of TOA can assist emergency clinicians in diagnosing and managing this potentially deadly disease.
-
Review
A scoping review of qualitative studies on pre-hospital analgesia administration and practice.
Pain is an exceedingly common complaint in the pre-hospital setting. Despite advancements in organizational protocols and guidelines, many emergency medical services (EMS) systems still fail to provide optimal pain management. This scoping review thus aimed to map the body of qualitative literature pertaining to factors influencing pre-hospital analgesia administration and practice in order to clarify concepts and understanding as well as to identify any knowledge gaps. ⋯ The factors influencing pre-hospital analgesia administration and practice remain incompletely understood. Existing tools and practice guidelines were also inadequate. This scoping review provided an overarching perspective of the extant literature, highlighting some of the significant barriers, enablers, and areas for further research.
-
Vital signs (VS) are used to triage and identify children at risk for severe illness. Few studies have examined the association of pediatric VS at emergency department (ED) discharge with patient outcomes. ⋯ Although many children were discharged from the ED with abnormal VS, few returned and required admission. Having 2 or more abnormal VS, age less than 3 years and higher acuity increased odds of revisit. Few children suffered serious adverse outcomes.
-
Meta Analysis
Outcome of cardiopulmonary resuscitation with different ventilation modes in adults: A meta-analysis.
The optimal airway management strategy for cardiac arrest remains unclear. This study aimed to compare the effects of different initial airway interventions on improving clinical outcomes based on the 2010 cardiopulmonary resuscitation (CPR) guidelines and later. ⋯ Opening the airway is significantly associated with improved clinical outcomes, and the findings suggest that effective ETI based on mask ventilation should be implemented as early as possible once the patient has experienced cardiac arrest.