Can J Emerg Med
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Multicenter Study
Do injection drug users have more adverse events during procedural sedation and analgesia for incision and drainage of cutaneous abscesses?
Injection drug users (IDUs) often undergo procedural sedation and analgesia (PSA) in the emergency department (ED). We compared adverse events (AEs) for IDUs to those for non-IDUs receiving PSA for incision and drainage of cutaneous abscesses. ⋯ For ED patients requiring PSA for incision and drainage, IDUs had an AE rate similar to that of non-IDUs but longer sedation and recovery times. In experienced hands, PSA may be as safe in IDUs as in patients who do not use injection drugs.
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It is believed that when patients present to the emergency department (ED) with recent-onset atrial fibrillation or flutter (RAFF), controlling the ventricular rate before cardioversion improves the success rate. We evaluated the influence of rate control medication and other variables on the success of cardioversion. ⋯ We demonstrated reduced successful electrical cardioversion of RAFF when patients were pretreated with either rate or rhythm control medication. Although rate control medication was not associated with increased success of chemical cardioversion, use of procainamide was. Slowing the ventricular rate prior to cardioversion should be avoided.
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Multicenter Study Comparative Study
Survey of emergency physicians' requirements for a clinical decision rule for acute respiratory illnesses in three countries.
ABSTRACTObjective:There are currently no widely used guidelines to determine which older patients with acute respiratory conditions require hospital admission. This study assessed the need for clinical decision rules to help determine whether hospital admission is required for patients over 50 years for three common respiratory conditions: chronic obstructive pulmonary disease (COPD), heart failure (HF), and community-acquired pneumonia (CAP). ⋯ EPs are likely to adopt highly sensitive clinical decision rules to predict the need for hospital admission for patients over 50 years with COPD, HF, or CAP.
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Multicenter Study
Bedside emergency department ultrasonography availability and use for blunt abdominal trauma in Canadian pediatric centres.
To quantify the current availability and use of bedside emergency department ultrasonography (EDUS) for blunt trauma at Canadian pediatric centres and to identify any perceived barriers to the use of bedside EDUS in such centres. ⋯ Bedside EDUS is currently used in almost half of pediatric trauma centres, a frequency that is significantly lower than adult centres. Physicians in pediatric centres who use ultrasonography report that it has a high utility, and a great majority of physicians at pediatric centres without EDUS plan to incorporate it in the future. The main reported barriers to its use are a lack of training and a lack of equipment availability.
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Randomized Controlled Trial Multicenter Study Comparative Study
Dopamine versus norepinephrine in the treatment of shock.
Which vasopressor agent, norepinephrine or dopamine, is superior in the treatment of shock? ⋯ The authors of this study set out to compare 28-day mortality in patients with shock who were treated with either dopamine or norepinephrine as initial vasopressor therapy. The authors' secondary outcome measures included mortality beyond 28 days and adverse events associated with each agent.