Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
To describe the experience of a residency program in emergency medicine with an intensive observational evaluation of resident performance in the ED. ⋯ The program provided the faculty with protected teaching time, an opportunity to share clinical pearls, and unique insights into resident performance that are not obvious during standard clinical interactions.
-
To review the types of injuries due to law enforcement (K-9) dog bites and address related management issues. ⋯ Attention to potential deep injuries of nerves, vessels, and the musculoskeletal system is essential with law enforcement dog bites. Injuries associated both with pursuit and arrest and with the bites themselves must be identified and assessed. Guidelines for the ED treatment of patients with law enforcement dog bite injuries are proposed.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparison trial of four injectable anesthetics for laceration repair.
To compare four injectable anesthetics (buffered 1% lidocaine, buffered 1% lidocaine with epinephrine, plain 1% lidocaine with epinephrine, and 0.5% diphenhydramine with epinephrine) for pain of infiltration and effectiveness of anesthesia during suturing of minor lacerations. ⋯ Buffered lidocaine with epinephrine and lidocaine with epinephrine were more effective anesthetics during suturing, according to both the physicians and the patients. There was a tendency toward less pain with infiltration in buffered solutions, compared with plain lidocaine with epinephrine, but the comparisons did not reach statistical significance. Diphenhydramine with epinephrine was more painful to inject than were buffered lidocaine with epinephrine and lidocaine with epinephrine, and was less effective anesthetically than the other three solutions.
-
To evaluate the effectiveness of propofol and fentanyl when used by emergency physicians (EPs) for systemic sedation and analgesia in the ED. ⋯ Propofol appears to be an effective agent to provide systemic sedation and analgesia when used in conjunction with fentanyl for procedures in the ED. Given its rapidity of onset and elimination, it may become a useful agent to EPs for i.v. sedation in the ED.