Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Randomized Controlled Trial
Laser-assisted anesthesia prior to intravenous cannulation in volunteers: a randomized, controlled trial.
Intravenous cannulation is common and painful. Absorption of topical anesthetics is limited by the stratum corneum, the outermost layer of the epidermis. A single pulse of an erbium:yttrium-aluminum-garnet (Er:YAG) laser irradiation can remove an area of the stratum corneum, leading to enhanced uptake of topical agents, such as lidocaine, while leaving the rest of the epidermis intact. ⋯ Pretreatment of the skin with a laser device followed by a 5-minute topical lidocaine application reduces the pain of IV cannulation in volunteers.
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Comparative Study
The accuracy and completeness of data collected by prospective and retrospective methods.
To describe and test a model that compares the accuracy of data gathered prospectively versus retrospectively among adult emergency department patients admitted with chest pain. ⋯ Information obtained retrospectively from the abstraction of medical records is measurably less accurate than information obtained prospectively from research subjects. For certain items, more than half of the information is not available. This loss of information is related to the data types included in the study and by the assumptions that a researcher performing a retrospective study makes about implied versus explicitly stated responses. A model of information flow that incorporates the concepts of reliability and validity can be used to measure some of the loss of information that occurs at each step along the way from subject to clinician to medical record abstractor.
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Clinical Trial
Octylcyanoacrylate for the treatment of small, superficial, partial-thickness burns: a pilot study.
Octylcyanoacrylate (OCA) is a tissue adhesive used to close wounds and to treat minor abrasions. ⋯ The results of this pilot study suggest that OCA may be useful for some, but not all, small, superficial, partial-thickness burns. Further studies may help clarify the indications and contraindications to proper usage of OCA in small, superficial burns.
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Historical Article
The influence of critical care medicine on the development of the specialty of emergency medicine: a historical perspective.
Through their largely concurrent development, the specialties of emergency medicine and critical care medicine have exerted a great deal of influence on each other. In this article, the authors trace the commonalities that emergency medicine and critical care medicine have shared and report on the historical relationship between the two specialties. As issues between emergency medicine and critical care medicine continue to emerge, the authors hope to inform the current discussion by bringing to light the controversies and questions that have been debated in the past.
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Neurologic complaints are a frequent cause of emergency department visits. The morbidity and mortality of neurologic complaints such as headache and stroke can be extensive. Thus, emergency medicine residency programs should ensure adequate training in such neurologic emergencies. The authors sought to determine what methods are being used to educate residents on neurologic emergencies. ⋯ Currently, the primary method of educating residents to treat neurologic emergencies is through didactic lectures, as opposed to clinical rotations in neurology or neurosurgery. Improving resident education in neurologic emergencies within the current educational format must focus on improving didactic lectures in neurologic topics. Expanding clinical rotations or electives to enhance education in neurologic emergencies also warrants future attention.