J Emerg Med
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of ultrasound-guided and standard landmark techniques for knee arthrocentesis.
Ultrasound is a useful adjunct to many Emergency Department (ED) procedures. Arthrocentesis is typically performed using a landmark technique but ultrasound may provide an opportunity to improve arthrocentesis performance. ⋯ US-guided knee arthrocentesis technique does not improve overall success of obtaining joint fluid aspirate vs. the standard LM and palpation technique. An US-guided approach does not result in more pain for the patient, takes no additional time to perform and, at least for novice physicians, leads to more fluid aspiration and greater novice provider confidence with the procedure. Further studies with more participants and standardization of anesthetic quantity are required to validate these findings.
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Randomized Controlled Trial
Emergency medicine resident performed bedside ultrasonography of the gallbladder in non-fasted healthy volunteers.
Gallbladder ultrasonography is a commonly performed test in the emergency department. It is unknown whether a non-fasting state alters the visualization of the gallbladder by emergency medicine (EM) residents. ⋯ EM residents are able to visualize the gallbladder in non-fasted healthy volunteers.
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Prior studies show that lactate is a useful prognostic marker in sepsis. ⋯ A point-of-care testing device provides a reliable and feasible way to measure serum lactate at the bedside. The pH and base excess were less helpful.
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Methicillin-resistant Staphylococcus aureus (MRSA) has a high prevalence in Emergency Departments (EDs). The objective of this study was to determine the ability of emergency physicians to predict MRSA infection in purulent wounds. A prospective observational study was conducted in an urban, tertiary academic center in ED patients presenting with purulent wounds and abscesses that received wound culture. ⋯ Prevalence was 64%. Only intravenous drug use was significantly associated with MRSA. Emergency physician's suspicion of MRSA infection is a poor predictor of MRSA infection.
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Disposable pulse oximetry sensors designed for the finger are sometimes placed on the forehead. Although finger sensors have not been designed to accurately measure arterial oxygen saturation when placed on other body parts, they are used on the forehead when an oximetry waveform cannot be obtained from the finger. ⋯ Pulse oximetry measurements taken on the forehead using a disposable finger sensor were inaccurate in over half of the subjects. Therefore, disposable finger oximetry sensors should not be placed on the forehead.