Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Comparison of succinylcholine and rocuronium for first-attempt intubation success in the emergency department.
The objective was to determine the effect of paralytic type and dose on first-attempt rapid sequence intubation (RSI) success in the emergency department (ED). ⋯ Succinylcholine and rocuronium are equivalent with regard to first-attempt intubation success in the ED when dosed according to the ranges used in this study.
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Emergency medicine (EM) in North America has been undergoing significant transformation since the new century. Recent health care reform has put it center stage. Access demand for acute care is increasing at the same time the number of qualified emergency physicians entering service has reached a plateau. Physician assistants (PAs), one alternative, are employed in emergency departments (EDs), but little is known about the impact of their role. ⋯ The use of PAs in EDs is increasing, and this expansion is due to necessity in staffing and economy of scale. Unique uses of PAs include wound management, acute care transfer management to the wards, and rural health emergency staffing. While their role seems to be expanding, this assessment identified gaps in deployment research using appropriate outcome measures in the area of clinical effectiveness of PAs.
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Medication error prevention has become a priority in health care. The Joint Commission recommends that a list of medications, dosages, and allergies be obtained from all patients. The authors sought to determine the accuracy of medication history taking in emergency department (ED) triage. The hypothesis was that there would be significant discrepancies between medications listed in triage and those the patient was actually taking. ⋯ Medication histories performed in ED triage are inaccurate and incomplete.
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More than a decade ago, the city of Philadelphia began allowing police transport of penetrating trauma patients. ⋯ Although unadjusted mortality appears to be higher in PD subjects, these findings are explained by the more severely injured population transported by PD. The current practice of permitting police officers to transport penetrating trauma patients should be continued.