Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of proparacaine and tetracaine eye anesthetics.
To compare two topical eye anesthetics, proparacaine and tetracaine, for pain of instillation and duration of activity. ⋯ Proparacaine eye drops cause less pain than tetracaine eye drops upon instillation. Anesthesia from proparacaine last slightly longer. These properties make proparacaine preferable to tetracaine.
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To determine the availability and relative use of pediatric analgesia and sedation at sites of U.S. emergency medicine residency training programs. ⋯ Emergency medicine residencies generally have available agents for pain control and conscious sedation in children, although the agents used vary widely. Appropriate instruction by trained faculty should enhance resident experience with pediatric pain control and sedation.
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To compare timed inspiratory-cycle endotracheal (ET) instillation of epinephrine (EPI) with instillation during apnea during CPR. ⋯ When other aspects of ET EPI instillation are optimized and controlled during porcine hypoxic-hypercarbic arrest, timed inspiratory-cycle installation of ET EPI (50 microgram(s)/kg) results in an improved bilateral DIST and greater exogenous EPI absorption. However, in this severe pediatric asphyxial arrest model using a 50-microgram(s)/kg dose, inspiratory-cycle instillation does not improve the resuscitation rate or hemodynamic response over currently recommended instillation during apnea.
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In clinical practice, thoracotomy and other critical emergency procedures are rarely required. Consequently, medical students and residents have difficulty acquiring procedural competency in these critical procedures. The authors developed objective written, computer, and animal-model assessments of thoracotomy procedural competency to permit comparison of the reliability and validity of these three procedural assessment modalities. ⋯ This study demonstrates that critical emergency medicine procedures can be evaluated reliably and validly using computer simulation and animal-model assessments. Neither previous thoracotomy experience nor knowledge of procedure content adequately predicts thoracotomy competency.
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To associate the efficacy of topical anesthesia of a tetracaine-adrenaline-cocaine solution (TAC) with the duration of skin contact. ⋯ TAC is most effective as a topical anesthetic when applied for more than 20 minutes prior to suturing.