European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial
Mid and long-term effects of a SBIRT program for at-risk drinkers attending to an emergency department. Follow-up results from a randomized controlled trial.
SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term follow-up results of a specialized SBIRT program. A short-term follow-up after 1.5 months showed encouraging results, with more than a 20% greater reduction of at-risk drinking in the intervention group and more than double of successful referrals to specialized treatment. ⋯ In this secondary analysis for mid- and long-term effects of a specialized SBIRT program, there was no significant difference in the reduction of risky drinkers at 18 weeks and 1 year. The small size of the studied sample and the low retention rate precluded any significant conclusion, although point estimates suggest a positive effect. Overall, SBIRT programs are an effective tool to reduce alcohol use at short time and to refer patients to specialized treatment; however, its effects seem to decay over time.
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Randomized Controlled Trial
Quality of dispatcher-assisted vs. automated external defibrillator-guided cardiopulmonary resuscitation: a randomised simulation trial.
Quality of hands-only cardiopulmonary resuscitation (CPR) is an important determinant of resuscitation outcome for cardiac arrest patients cared for by lay rescuers. We designed a simulation trial to assess and compare the quality of CPR among untrained lay people under two different scenarios: automated external defibrillator (AED)-guided and dispatcher-assisted CPR. ⋯ Although guided CPR helps untrained people to initiate resuscitation manoeuvres, the quality of CPR was poor in both groups. Telephone guidance improved the proportion of compressions that achieved adequate chest compression and recoil but did not optimise the compression rate.
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Randomized Controlled Trial
Inhaled methoxyflurane for the management of trauma related pain in patients admitted to hospital emergency departments: a randomised, double-blind placebo-controlled trial (PenASAP study).
Oligo-analgesia is common in the emergency department (ED). This study aimed at reporting, when initiated by triage nurse, the superior efficacy of inhaled methoxyflurane plus standard of care (m-SoC) analgesia versus placebo plus SoC (p-SoC) for moderate-to-severe trauma-related pain in the hospital ED. ⋯ In this study, we report that methoxyflurane, initiated at triage nurse as part of a multimodal analgesic approach, is effective in achieving pain relief for trauma patients. This effect was particularly pronounced in the severe pain subgroup.
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Randomized Controlled Trial Observational Study
'Stop sign' position for subclavian ultrasound: a single-blinded observational study of subclavian vein dimensions.
Right subclavian vein (SCV) dimensions were evaluated on ultrasound and whether these change when the right upper limb is in a neutral position compared with the 'stop sign' position (shoulder abducted and externally rotated to 90°, elbow flexed to 90°), and when patients were positioned 30° head-up compared with lying supine. ⋯ Utilizing the stop sign position does not change SVC dimensions when patients are supine, however, may improve dimensions when lying supine is contraindicated.