Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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The objective was to determine if geospatial techniques can be used to inform targeted community consultation (CC) and public disclosure (PD) for a clinical trial requiring emergency exception from informed consent (EFIC). ⋯ Geospatial techniques and hospital data records can be used to characterize potential subjects and delineate a high-risk population to inform directed CC and public disclosure strategies.
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The objective was to describe patient and facility characteristics of emergency department (ED) observation services in the United States. ⋯ Over one-third of U.S. EDs have an OU. Short-stay admission patients have similar characteristics as ED observation patients and may represent an opportunity for the growth of OUs.
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Africa's first residency training program in emergency medicine (EM) was established at the University of Cape Town (UCT)/Stellenbosch University (SUN) in 2004. There have since been four classes for a total of 29 graduates from this program who are practicing, teaching, and leading EM. This article describes the structure of the program and discusses the history and major drivers behind its founding. We report major changes, cite ongoing challenges, and discuss lessons learned from the program's first 7 years that may help advise other nascent training programs in developing countries.
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Randomized Controlled Trial
Ketamine/propofol versus midazolam/fentanyl for procedural sedation and analgesia in the emergency department: a randomized, prospective, double-blind trial.
The authors performed a prospective, double-blinded, randomized trial with emergency department (ED) patients requiring procedural sedation and analgesia (PSA) for repair of deep traumatic lacerations and reduction of bone fractures, to compare the ketamine/propofol (ketofol) combination with the midazolam/fentanyl (MF) combination. ⋯ The ketamine/propofol combination provides adequate sedation and analgesia for painful procedures and appears to be a safe and useful technique in the ED.
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Automated bladder ultrasound (ABUS) devices are portable and designed to provide automated measurement of bladder volume. They are simple and require minimal training compared to conventional real-time ultrasound (RTUS). Their most common application in the acute pediatric setting is to assess bladder volumes prior to performing invasive urine collection such as suprapubic aspiration (SPA) in children younger than 2 years of age. However, data on ABUS in young children are limited. The aim of this study was to assess the repeatability and accuracy of one type of ABUS, the BladderScan, in measuring of bladder volume in children aged 0 to 24 months when compared with RTUS. ⋯ This study showed poor repeatability and accuracy in bladder volume measurements using BladderScan ABUS when compared to RTUS. The ABUS method does not appear to be a reliable method for assessing bladder volumes in children aged 0 to 24 months prior to bladder instrumentation.