European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Comparative Study Observational Study
Ultrasonographic comparison of two landmarks for the internal jugular vein: high versus conventional approach.
We assessed and compared two landmarks (conventional vs. high approach) used in internal jugular vein (IJV) cannulation with respect to the degree of overlap with the carotid artery (CA) and the cross-sectional area (CSA) of the IJV using ultrasonography. ⋯ The high approach for IJV cannulation decreased both the degree of overlap with the CA and CSA of the IJV and increased the depth of the IJV from the skin compared with the conventional approach.
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Comparative Study
Comparison of patient and caregiver perception of pain from commonly performed accident and emergency services procedures.
To compare the perception by naive patients, emergency services clinicians and nurses, of healthcare-induced pain for procedures performed frequently by accident and emergency services. ⋯ Caregivers should be aware of the most feared procedures by patients to establish pre-emptive analgesia when possible, inform patients and achieve reassurance.
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Many studies illustrate variation in pain management protocols in emergency medicine. This study examines analgesia frameworks in emergency departments (EDs) in multiple countries, compares them with the recent literature, and illuminates the variability in protocols and treatment. A survey was conducted assessing the pain management framework and practices in a convenience sample of 40 hospitals distributed over 22 countries. ⋯ All (100%) reported analgesia administration in the trauma room. Oral paracetamol (67.5%) and intravenous morphine (92.5%) were the most commonly used analgesics. The variability in the pain management framework is high among EDs worldwide, highlighting the need for more international uniformity in analgesia practices in the ED.
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Identifying patients at risk of transfer to the ICU upon arrival to the Emergency Department (ED) might direct early therapy and optimize transfers. However, among the many ED patients, it is difficult to pinpoint the few who insidiously deteriorate to an ICU-requiring level. The aim of this study was to identify predictors in background information, vital values and blood-gas analysis for transfer to ICU 3-36 h after arrival among nontrauma ED patients. ⋯ The predictors identified could be used as part of ED triage to identify high-risk patients for ICU. These findings should be examined in a well-designed prospective cohort study.