J Emerg Med
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Randomized Controlled Trial
Time to Loss of Preoxygenation in Emergency Department Patients.
In patients requiring emergency rapid sequence intubation (RSI), 100% oxygen is often delivered for preoxygenation to replace alveolar nitrogen with oxygen. Sometimes, however, preoxygenation devices are prematurely removed from the patient prior to the onset of apnea, which can lead to rapid loss of preoxygenation. ⋯ In this population of non-critically ill ED patients, most had loss of preoxygenation after 5 breaths if all oxygen devices were removed, and after 8 breaths if a nasal cannula was left in place. These data suggest that during ED RSI, preoxygenation devices should be left in place until the patient is completely apneic.
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Randomized Controlled Trial
Evidence-Based Medicine Improves the Emergent Management of Peritonsillar Abscesses Using Point-of-Care Ultrasound.
Physical examination for peritonsillar abscess (PTA) has limited sensitivity. Traditional management involves blind needle aspiration, which has a false negative rate of 10-24%. A randomized controlled trial by Costantino et al. demonstrated that point-of-care ultrasound (POCUS) improves PTA management. ⋯ POCUS use has increased for PTA treatment, improves aspiration, and decreases consultations, CTs, return visits, and LOS.
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Randomized Controlled Trial
Pragmatic Randomized Controlled Pilot Trial on Trigger Point Injections With 1% Lidocaine Versus Conventional Approaches for Myofascial Pain in the Emergency Department.
Myofascial neck and back pain is an increasingly common chief symptom in the emergency department. Currently, there are no widely accepted conventional therapies, and there is little evidence on the efficacy of interventions such as trigger point injections (TPIs). ⋯ TPI is an effective method for managing myofascial pain in the emergency department. This study indicates it may improve pain compared with conventional methods, reduce length of stay in the emergency department, and reduce opioid prescriptions on discharge.
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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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Randomized Controlled Trial
Emergency Department Stopping Elderly Accidents, Deaths and Injuries (ED STEADI) Program.
Falls are among the leading cause of emergency department (ED) visits. ⋯ Overall, in this study, subjects who had their fall-risk interventions facilitated by a decision tool chose to participate in interventions more than control subjects. However, they did not complete the interventions or fall less often than their counterparts in the control arm. Future study is needed to determine the effect of CDC screening guidelines and interventions facilitated by a decision aid on fall outcomes and their application in the ED population.