Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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Comparative Study
Underdosing of midazolam in emergency endotracheal intubation.
To determine whether midazolam, when used as an induction agent for emergency department (ED) rapid-sequence intubation (RSI), is used in adequate and recommended induction doses (0.1 to 0.3 mg/kg), and to compare the accuracy of the dosing of midazolam for ED RSI with the accuracy of dosing of other agents. ⋯ Underdosing of midazolam during ED RSI is frequent, and appears to be related to incorrect dosage selection, rather than to a deliberate intention to reduce the dose used.
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This article summarizes discussions held during a conference on outcomes research in emergency medical services for children. It provides detailed information on existing outcome measures for pediatric minor head injury. Benefits and/or limitations in their applicability for use in pediatric emergency medicine and pediatric minor head injury research are highlighted.
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Randomized Controlled Trial Clinical Trial
The self-inflating bulb as an airway adjunct: is it reliable in children weighing less than 20 kilograms?
To confirm the ability of the self-inflating bulb to indicate endotracheal tube (ETT) position in children weighing less than 20 kilograms, and to determine whether the presence of air in the stomach affects the bulb's accuracy. ⋯ The self-inflating bulb is a reliable method of detecting endotracheal tube position in children weighing less than 20 kg, even with the use of uncuffed endotracheal tubes. Furthermore, the presence of air in the stomach, simulating field conditions, does not affect bulb effectiveness in detecting endotracheal tube position.
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Comparative Study
Comparison of perceived and actual times spent by residents performing ultrasound examinations on patients.
Emergency medicine (EM) ultrasonography (US) has become a part of residency education. More residents will be taking time during their shifts to perform bedside US examinations for educational purposes, thus further challenging time resources. ⋯ In this study, residents underestimated the amount of time spent performing an ultrasound examination. The small difference between the actual and perceived scan times was statistically significant; the clinical significance of this time difference is not known.
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Verbally administered numerical rating scales (NRSs) from 0 to 10 are often used to measure pain, but they have not been validated in the emergency department (ED) setting. The authors wished to assess the comparability of the NRS and visual analog scale (VAS) as measures of acute pain, and to identify the minimum clinically significant difference in pain that could be detected on the NRS. ⋯ The findings suggest that the verbally administered NRS can be substituted for the VAS in acute pain measurement.