Can J Emerg Med
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To assess the safety and effectiveness of intravenous regional anesthesia (Bier block) in the management of forearm injuries (i.e., forearm, wrist or hand) by primary care physicians at a diagnostic and treatment facility. ⋯ Bier block anesthesia is a safe, effective and reliable technique in an outpatient primary care setting. This technique is a useful modality for physicians who manage acute upper-extremity injuries.
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The trend toward operating Canadian hospitals at full capacity necessitates in some settings the transfer of patients from one hospital's emergency department (ED) to another hospital for admission, due to lack of bed availability at the first hospital. Our objectives were to determine how many and which patients are transported, to measure how much time is spent in the peri-transport process and to document any morbidity or mortality associated with these periods of transitional care. ⋯ Overcrowding of hospitals is a significant problem in many Canadian EDs, resulting in measurable increases in lengths of stay. Transfers arranged to other facilities for admission further prolong lengths of stay. Increased boarding times can result in missed medications, which may increase patient morbidity. Further study is needed to assess the need for capacity transfers and the possible risk to patients associated with periods of transitional care.
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Randomized Controlled Trial
Impact of a pressure-responsive flow-limiting valve on bag-valve-mask ventilation in an airway model.
Using a simulated airway model, we compared ventilation performance by emergency medical services (EMS) providers using a traditional bag-valve-mask (Easy Grip) resuscitator to their performance when using a new device, the SMART BAG resuscitator, which has a pressure-responsive flow-limiting valve. ⋯ The SMART BAG(R) provided ventilation performance that was more consistent with American Heart Association guidelines and delivered similar tidal volumes when compared with ventilation with a traditional bag-valve-mask resuscitator.