J Emerg Med
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Egypt plays a pivotal role in North Africa and the Middle East, and has the largest population of any Arab country and serves as a regional cultural hub. Emergency medicine as a field of study was first initiated at Alexandria University in 1978, but it was only formally recognized as a medical specialty in 2002. Since then, the prehospital system and practice of emergency medicine has evolved and grown. ⋯ Egypt has made great strides with respect to the delivery of emergency services, physician education and certification within the specialty of emergency medicine. Learning about these developments in Egypt will provide the reader with a compelling example of how an emergency system is developed in an advancing national setting.
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Meta Analysis
Endotracheal Tube Placement Confirmation by Ultrasonography: A Systematic Review and Meta-Analysis of more than 2500 Patients.
The integration of point-of-care ultrasound in endotracheal tube placement confirmation has been focus of many recent studies. ⋯ Ultrasonography is a valuable and reliable adjunct for endotracheal tube confirmation, including during cardiac arrest resuscitation.
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Randomized Controlled Trial
External Cardiac Massage Training of Medical Students: A Randomized Comparison of Two Feedback Methods to Standard Training.
The most recent recommendations support learning of external cardiac massage (ECM) through feedback devices. ⋯ The use of a feedback device used for ECM training improves the quality of immediate retention of technical ECM skills compared with traditional teaching in medical students. At 3 months, the 2 groups with feedback retained a high level of performance. No significant difference could be demonstrated between the 2 feedback methods.
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Viscoelastography (VE) is an established method to identify coagulopathies in various disease processes. Clinical decisions can be made with real-time tracings and quantitative values at the bedside. Thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) have been utilized in several disease states with clinical varying success. ⋯ This review serves as a way for emergency medicine clinicians to utilize VE in their practice and provides an insightful literature overview.
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Review Case Reports
Argyria, an Unexpected Case of Skin Discoloration From Colloidal Silver Salt Ingestion.
Argyria is a rare condition characterized by gray/blue dislocation of the skin caused by chronic exposure to silver salts. ⋯ We review the case of an 81-year-old man who presented to the emergency department after a motor vehicle accident, was incidentally found to have skin discoloration, and was ultimately diagnosed with argyria. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although most emergency physicians will not complete a toxicology fellowship, all emergency physicians are on the front line of toxicological presentations and should be able to recognize argyria and differentiate this condition from other causes of skin discoloration.