J Emerg Med
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Multicenter Study Comparative Study
Single-operator ultrasound-guided intravenous line placement by emergency nurses reduces the need for physician intervention in patients with difficult-to-establish intravenous access.
Emergency physicians (EPs) have become facile with ultrasound-guided intravenous line (USIV) placement in patients for whom access is difficult to achieve, though the procedure can distract the EP from other patient care activities. ⋯ ENs performing single-operator USIV placement in patients with difficult-to-establish i.v. access reduces the need for EP intervention.
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Randomized Controlled Trial
Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study.
Acute alcohol withdrawal syndrome (AAWS) is encountered in patients presenting acutely to the Emergency Department (ED) and often requires pharmacologic management. ⋯ A single dose of i.v. phenobarbital combined with a symptom-guided lorazepam-based alcohol withdrawal protocol resulted in decreased ICU admission and did not cause increased adverse outcomes.
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Comparative Study
Hemodynamic effect of external chest compressions at the lower end of the sternum in cardiac arrest patients.
Little is known about the hemodynamic effects of chest compression at different positions on the sternum during cardiopulmonary resuscitation (CPR). ⋯ Compared to standard compression, alternative compression results in a higher peak arterial pressure and end-tidal CO2 pressure, but no change in coronary perfusion pressure.
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Comparative Study
Pilot study comparing sepsis management with and without electronic clinical practice guidelines in an academic emergency department.
Sepsis is a potentially life-threatening condition that requires urgent management in an Emergency Department (ED). Evidence-based guidelines for managing sepsis have been developed; however, their integration into routine practice is often incomplete. Care maps may help clinicians meet guideline targets more often. ⋯ A sepsis eCPG experienced variable use; however, physicians using the eCPG achieved more quality-of-care targets for SS/SS. Strategies to increase the utilization of eCPGs in Emergency Medicine seem warranted.