Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Multicenter Study
CPR training and CPR performance: do CPR-trained bystanders perform CPR?
To determine factors associated with cardiopulmonary resuscitation (CPR) provision by CPR-trained bystanders and to determine factors associated with CPR performance by trained bystanders. ⋯ A minority of CPR-trained bystanders performed CPR. CPR provision was more common in CPR-trained bystanders with more than a high-school education and when CPR training had been within five years. Previously espoused reasons for not doing CPR (mouth-to-mouth, infectious-disease risk) were not the reasons that bystanders cited for not doing CPR. Further work is needed to maximize CPR provision after CPR training.
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To evaluate whether automated external defibrillator (AED) training and AED availability affected the response of volunteer rescuers and performance of cardiopulmonary resuscitation (CPR) in presumed out-of-hospital cardiac arrest (OOH-CA) during the multicenter Public Access Defibrillation Trial. ⋯ In the Public Access Defibrillation Trial, rates of CPR actions for presumed OOH-CA victims were low but similar for CPR and CPR+AED responding volunteer rescuers. Factors associated with volunteer response, CPR action initiation, and AED activation warrant further investigation.
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Resident teaching is a competency that must be recognized, developed, and assessed. The ACGME core competencies include the role of physician as educator to "educate patients and families" and to "facilitate the learning of students and other health care professionals." Residents spend a significant proportion of their time in teaching activities, and students report achieving much of their clinical learning from their interactions with residents. Although many residents enjoy their critical role as teacher, many do not feel well prepared to teach. ⋯ The goal of these modules is to provide learning objectives and an initial structure through which residents could improve basic teaching skills. Many of these skills are adaptable to residents' interactions with each other and with students, other healthcare professionals, and patients. Each module and corresponding teaching exercises can be found at http://www.saem.org.
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To obtain a detailed description of the injury scene in an attempt to identify methods for prevention and to describe the morbidity and mortality of children who present to an urban pediatric emergency department (ED) with an injury caused by a falling television. ⋯ Children may present to the ED with injuries caused by falling televisions. These injuries are usually not severe; however, the potential for severe injury exists, and some children may require ICU monitoring. Our data indicate a lack of parental awareness and an absence of primary prevention as a root cause for this problem. Thus, more aggressive education to warn parents about the risk of injury must be implemented so that more families will take the time to place their televisions safely.
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Randomized Controlled Trial
Laser-assisted anesthesia reduces the pain of venous cannulation in children and adults: a randomized controlled trial.
Application of topical anesthetics before intravenous (IV) cannulation is effective yet limited by delayed transdermal absorption. The authors evaluated a handheld laser device to enhance topical anesthetic absorption by ablating the stratum corneum, the major barrier to drug absorption through the skin. The hypothesis was that laser-assisted anesthesia would reduce the pain of IV cannulation in emergency department (ED) patients. ⋯ Pretreatment of the skin with a laser device followed by a five-minute topical lidocaine 4% application reduces the pain of IV cannulation in ED adult and pediatric patients.