J Emerg Med
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We sought to measure the prevalence of practicing procedures on the recently dead in emergency departments. Surveys were mailed to all medical students, interns, residents in Emergency Medicine, emergency physicians, and trauma team leaders working in the teaching hospitals of a city with a population of 600,000. Of 447 distributed surveys, 222 (49%) were returned. ⋯ The prevalence of practicing procedures on recently dead patients appears to be less than has been reported previously. Intubation is the most commonly practiced procedure on recently dead patients. None of the participants obtained consent before practicing a procedure.
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Transcutaneous cardiac pacing is a temporary treatment of hemodynamically unstable bradycardias. However, the rhythmic skeletal muscle contractions that occur during external pacing can make it difficult to assess the hemodynamic status of the patient. We report a case of using bedside ultrasound to assess the effectiveness of transcutaneous pacer capture.
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Toxins have had major roles in our societies for thousands of years. Interactions between surgeons, both generalists and subspecialists, and those caring for poisoned patients have been extensive throughout history. The advancement of the science of toxicology, the development of regional poison control centers, the development of emergency medicine, and the development of the subspecialty of medical toxicology have led to more appropriate and creative interactions between medical toxicologists, emergency physicians, and surgeons. This article will review the diverse interfaces between the medical toxicologist and the surgeon.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of wire-guided cricothyrotomy versus standard surgical cricothyrotomy technique.
We compared a wire-guided cricothyrotomy technique vs. standard surgical cricothyrotomy in terms of accuracy in placement, complications, performance time, incision length, and user preference. We conducted a randomized, crossover controlled trial in which Emergency Medicine (EM) attendings and residents performed cricothyrotomies by both standard and wire-guided techniques (using a commercially available kit) on human cadavers after a 15-min training session. Procedure time, incision length, and physician preference were recorded. ⋯ Overall, 14 of 15 physicians stated that they preferred the wire-guided to the standard technique. Our data suggest that this wire-guided cricothyrotomy technique is as accurate and timely to use as the standard technique and is preferred by our physician operators. In addition, the technique results in a smaller incision on human cadaver models.